Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases.
OBJECTIVES: We investigated whether advanced age affects peri-operative outcomes after robotic-assisted pulmonary lobectomies.
MATERIALS AND METHODS: We retrospectively analyzed patients who underwent robotic-assisted lobectomy by one surgeon over a 5-year period. Rates of postoperative complications were compared according to age group. Other outcomes, such as intraoperative complications, hospital length of stay (LOS), and in-hospital mortality, were also compared.
RESULTS: A total of 287 patients were included (mean age 67.1yr). Group A had 65 patients of advanced age≥75yr (range 75-87yr; 37 men, 28 women); Group B had 222 patients aged <75yr >(range 29-74yr; 95 men, 127 women). Group A had 10/65 (15.4%) patients with robotic-related intraoperative complications, compared to 10/222 (4.5%) for Group B (p=0.002), with the most frequent intraoperative complications being bleeding from a pulmonary vessel (10.8% vs. 4.5%, p=0.06), bronchial injury (3.1% vs. 0.9%, p=0.18), and injury to the phrenic or recurrent laryngeal nerve (1.5% vs. 0.4%, p=0.33). There were 28/65 (43.1%) patients in Group A with postoperative complications compared to 76/222 (34.2%) in Group B (p=0.19). While operative times were similar (p=0.42), Group A had longer median hospital LOS of 6±0.9days compared to 4±0.3days for Group B (p=0.02).
CONCLUSION: While younger patients have lower risk of robotic-related intraoperative complications and shorter hospital LOS, elderly patients do not have increased overall or emergent conversion rates to open lobectomy, overall postoperative complications rates, or in-house mortality compared to younger patients. Thus, robotic-assisted pulmonary lobectomy is feasible and relatively safe for patients of advanced age.
Published In/Presented At
Kass, K. S., Velez-Cubian, F. O., Zhang, W. W., Toosi, K., Tanvetyanon, T., Rodriguez, K. L., Thau, M. R., Garrett, J. R., Moodie, C. C., Fontaine, J. P., & Toloza, E. M. (2017). Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases. Journal of geriatric oncology, 8(2), 102–107. https://doi.org/10.1016/j.jgo.2016.11.003
Medical Education | Medicine and Health Sciences
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