Video-Assisted Thoracoscopic Surgery and Perioperative Management for Elderly Patients
- VernacularTitle:高龄患者电视胸腔镜手术及围术期处理
- Author:
Jingdi WANG
;
Tiansheng YAN
;
Dandan LIU
- Publication Type:Journal Article
- Keywords:
Elderly patients;
Video-assisted thoracoscopic surgery;
Perioperative period
- From:Chinese Journal of Minimally Invasive Surgery
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report our experience on video-assisted thoracoscopic surgery(VATS)and perioperative management for patients over 70 years old.Methods From May 1998 to May 2008,78 patients over 70 years old were treated by VATS.Operative risk was evaluated by measuring forced expiratory volume in first second(FEV1),diffuse capacity of carbon monoxide(DLCO),and left ventricular ejection fraction(LVEF),and artery blood gas analysis and exercise test before the operation.VATS(n=46)or video-assisted minithoracotmy(n=32)was carried out under general anesthesia with a double-lumen tube.Extubation was delayed in 11 patients after the procedures and mechanical ventilation was employed to smooth anesthesia recovery.Results Postoperative pathological examination showed primary lung cancer in 20 cases,benign pulmonary lesions in 26,pleural mesothelioma in 3,malignant pleural metastasis in 5,empyema in 5,benign mediastinal tumor in 15,hiatal hernia in 3,and esophageal leiomyoma in 1.Postoperative morbidity was 33.3%(26/78)in this series,none of the patients died during the operation;the perioperative mortality was 2.6%(2/78).Conclusions VATS is safe for elderly patients.Satisfying outcomes can be achieved through strict preoperative evaluation,proper operative method and active management for postoperative complications.
