Pulmonary resection in the elderly Journal Article
| Authors: | Castillo, M. D.; Heerdt, P. M. |
| Article Title: | Pulmonary resection in the elderly |
| Abstract: | PURPOSE OF REVIEW: With increasing longevity, altered demographics of the lung cancer population, and preoperative interventions to enhance the efficacy of surgical therapy, increasing numbers of elderly people will present for anesthesia and pulmonary resection. RECENT FINDINGS: The geriatric population often exhibits wide disparity between chronologic and physiologic senescence which is underscored by data indicating that outcome following lung resection for cancer is influenced more by tumor stage, preoperative functional status and comorbidities than age alone. Nonetheless, the normal process of cardiopulmonary aging can limit the physiological reserve necessary to compensate for perioperative stress even in otherwise healthy elderly patients. Data indicate a relatively favorable risk-benefit relationship for lung resection in the elderly given the poor prognosis for patients undergoing palliative care or chemotherapy or radiation alone. Emerging experience now suggests that minimally invasive surgical techniques for the treatment of lung cancer may parallel conventional thoracotomy in terms of oncologic efficacy while decreasing perioperative morbidity in the elderly. SUMMARY: The combination of an aging population, recent advances in neoadjuvant therapies, data supporting the oncologic efficacy of resection, and minimally invasive surgical techniques strongly suggests that more elderly patients will be candidates for surgical management of their lung cancer, thus presenting anesthesiologists with unique challenges. © 2007 Lippincott Williams & Wilkins, Inc. |
| Keywords: | cancer chemotherapy; treatment outcome; aged; cancer surgery; surgical technique; review; risk benefit analysis; cancer patient; cancer radiotherapy; lung lobectomy; lung non small cell cancer; lung resection; thoracotomy; morbidity; palliative therapy; lung cancer; risk assessment; postoperative complication; cardiovascular disease; adjuvant chemotherapy; endoscopic surgery; surgical risk; lung; medical specialist; surgical mortality; intermethod comparison; minimally invasive surgery; surgical procedures, minimally invasive; aging; perioperative period; high risk population; senescence; lung function; chronic obstructive lung disease; respiratory failure; heart function; thoracic surgical procedures; anesthesia; surgical patient; cardiopulmonary function; cardiovascular physiology |
| Journal Title: | Current Opinion in Anaesthesiology |
| Volume: | 20 |
| Issue: | 1 |
| ISSN: | 0952-7907 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2007-02-01 |
| Start Page: | 4 |
| End Page: | 9 |
| Language: | English |
| DOI: | 10.1097/ACO.0b013e32801271fa |
| PUBMED: | 17211159 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "CODEN: COAEE" - "Source: Scopus" |
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