Skip to main content Accessibility help
×
Home
  • Print publication year: 2018
  • Online publication date: January 2018

12 - Thoracic Surgery in the Elderly

from Section 3 - Intraoperative Considerations
1.Age invaders. The Economist. 2014. Available from: www.economist.com/news/briefing/21601248-generation-old-people-about-change-global-economy-they-will-not-all-do-so (Accessed July 12, 2017).
2.Vincent, GK, Velkoff, VA. The Next Four Decades, The Older Population in the United States: 2010 to 2050, Current Population Reports, P25-1138. Washington, DC, US Census Bureau, 2010.
3.Siegel, R, Naishadham, D, Jemal, A. Cancer statistics, 2012. CA Cancer J Clin. 2012; 62:1029.
4.Etzioni, DA, Liu, JH, Maggard, MA, et al. The aging population and its impact on the surgery workforce. Ann Surg. 2003; 238:170177.
5.Boffa, DJ, Allen, MS, Grab, JD, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg. 2008; 135:247254.
6.Minino, AM. Death in the United States, 2011. NCHS Data Brief. 2013; 115:18.
7.Janssens, JP, Pache, JC, Nicod, LP. Physiological changes in respiratory function associated with ageing. Eur Respir J. 1999; 13:197205.
8.Janssens, JP. Aging of the respiratory system: impact on pulmonary function tests and adaptations to exertion. Clin Chest Med. 2005; 26:469484.
9.Sprung, J, Gajic, O, Warner, DO. Review article: age related alterations in respiratory function: anesthetic considerations. Can J Anaesth. 2006; 53(12):12441257.
10.Niewoenner, D, Kleinerman, J. Morphologic basis of pulmonary resistance in human lung and effects of aging. J Appl Physiol. 1974; 36:412418.
11.Teramoto, S, Ishii, M. Aging, the aging lung, and senile ephysema are different. Am J Respir Crit Care Med. 2007; 175(2):197198.
12.Zaugg, M, Lucchinetti, E. Respiratory function in the elderly. Anesthesiol Clin N Am. 2000; 18(1):4758.
13.Svartengren, M, Falk, R, Philipson, K. Long term clearence from small airways decreases with age. Eur Respir J. 2005; 26(4):609615.
14.Sharma, G, Goodwin, J. Effect of aging on respiratory system physiology and immunology. Clin Interven Aging. 2006; 1(3):253260.
15.Brown, M, Hasser, EM. Complexity of age-related change in skeletal muscle. J Gerontol A Biol Sci Med Sci. 1996; 51(2):B117B123.
16.El Solh, AA, Ramadan, FH. Overview of respiratory failure in older adults. J Intensive Care Med. 2006; 21(6):345351.
17.Taylor, BJ, Johnson, BD. The pulmonary circulation and exercise responses in the elderly. Semin Respir Crit Care Med. 2010; 31:528538.
18.Humbert, IA, Robbins, J. Dysphagia in the elderly. Phys Med Rehabil Clin North Am. 2008; 19:853866.
19.Paulsen, F, Kimpel, M, Lockemann, U, et al. Effects of ageing on the insertion zones of the human vocal fold. J Anat. 2000; 196:4154.
20.Lalley, PM. The aging respiratory system: pulmonary structure, function and neural control. Respir Physiol Neurobiol. 2013; 187:199210.
21.Crapo, RO. The Aging Lung: Pulmonary Disease in the Elderly Patient. New York, Marcel Dekker, 1993:121.
22.Cardús, J, Burgos, F, Diaz, O, et al. Increase in pulmonary ventilation-perfusion inequality with age in healthy individuals. Am J Respir Crit Care Med. 1997; 156(2 Pt 1):648653.
23.Sorbini, LA, Grass, V, Solinas, E, et al. Arterial oxygen tension in relation to age in healthy subjects. Respiration. 1968; 25(1):313.
24.Connoly, MJ, Crowley, JJ, Charan, NB, et al. Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale. Thorax. 1992; 47:410413.
25.Sharma, G, Goodwin, J. Effect of aging on respiratory system physiology and immunology. J Clin Interven Aging. 2006; 1:253260.
26.Panda, A, Arjona, A, Sapey, E, et al. Humane innate immunosenescence: causes and consequences for immunity in old age. Trends Immunol. 2009; 30(7):325333.
27.Lowery, EM, Brubaker, AL, Kuhlmann, E, et al. The aging lung. Clin Interv Aging. 2013; 8:14891496.
28.Brunelli, A, Kim, AW, Berger, KI, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery. Chest 2013; 143(5 Suppl):e166Se190S.
29.Brunelli, A, Charloux, A, Bollinger, CT, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients. Eur Respir J. 2009; 34(1):1741.
30.Extermann, M, Aapro, M, Bernabei, R, et al. Task Force on CGA of the International Society of Geriatric Oncology. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005; 55(3):241252.
31.Schilling, T, Kozian, A, Kretzschmar, M, et al. Effect of propofol and desflurane anesthesia on the alveolar inflammatory response to one-lung ventilation. Br J Anesthesia. 2007; 99:368375.
32.Marik, PE, Kaplan, D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003; 124:328336.
33.Cedborg, AI, Sundman, E, Boden, K, et al. Pharyngeal function and breathing pattern during partial neuromuscular block in the elderly: effects on airway protection. Anesthesiology. 2014; 120:312325.
34.Matteo, RS, Ornstein, E, Schwartz, AE, et al. Pharmacokinetics and pharmacodynamics of rocuronium in elderly surgical patients. Anesth Analg. 1993; 77:11931197.
35.Cheng, YD, Duan, CJ, Zhang, H, et al. Clinical controlled comparison between lobectomy and segmental resection for patients over 70 years of age with clinical stage I non-small cell lung cancer. Eur J Surg Oncol. 2012; 38:11491155.
36.Miller, MR. Structural and physiological age-associated changes in aging lungs. Semin Respir Crit Care Med. 2010; 31:521527.
37.Lohser, J. Evidence-based management of one-lung ventilation. Anesthesiol Clin. 2008; 26(2):241272.
38.Unzueta, C, Tusman, G, Suarez-Sipmann, F, et al. Alveolar recruitment improves ventilation during thoracic surgery: a randomized controlled trial. Br J Anaesth. 2012; 108(3):517524.
39.Downs, JB, Robinson, LA, Steighner, ML, et al. Open lung ventilation optimizes pulmonary function during lung surgery. J Surg Res. 2014; 192:242249.
40.Kozian, A, Schilling, T, Schutze, H, et al. Ventilatory protective strategies during thoracic surgery: effects of alveolar recruitment maneuver and low-tidal volume ventilation on lung density distribution. Anesthesiology. 2011; 114:10251035.
41.Lin, F, Pan, L, Huang, B, et al. Pressure-controlled versus volume-controlled ventilation during one-lung ventilation in elderly patients with poor pulmonary function. Ann Thoracic Med. 2014:9(4) 203208.
42.Kozian, A, Kretzschmar, MA, Schilling, T. Thoracic anesthesia in the elderly. Curr Opin Anesthesiol. 2015; 28:29.
43.Searl, CP, Perrino, A. Fluid management in thoracic surgery. Anesthesiology Clin. 2012; 30:641655.
44.Arslantas, MK, Kara, HV, Tuncer, BB, et al. Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections. J Thorac Cardiovasc Surg. 2015; 149:314320.
45.Yao, S, Mao, T, Fang, W, et al. Incidence and risk factors for acute lung injury after open thoracotomy for thoracic diseases. J Thorac Dis. 2013; 5(4):456460.
46.Van der Heijden, M, Verheij, J, Amerongen, GP, et al. Crystalloid or colloid fluid-loading and pulmonary permeability, edema and injury in septic and non-septic patients. Crit Care Med. 2009; 37:12751281.
47.Lee, JH, Jeon, Y, Bahk, JH, et al. Pulse pressure variation as a predictor of fluid responsiveness during one-lung ventilation for lung surgery using thoracotomy: randomized controlled study. Eur J Anaesthesiol. 2011; 28:3944.
48.Suehiro, K, Okutani, R. Influence of tidal volume for stroke volume variation to predict fluid responsiveness in patients undergoing one-lung ventilation. J Anesth. 2011; 25:777780.
49.Abdallah, MS, Assad, OM. Randomised study comparing the effect of hydroxyethyl starch HES 130/0.4, HES 200/0.5 and modified fluid gelatin for perioperative volume replacement in thoracic surgery: guided by transoesophageal Doppler. EJCTA. 2010; 4:7684.
50.Zhang, J, Chen, CQ, Lei, XZ, et al. Goal directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study. Clinics (Sao Paulo). 2013; 68:10651070.
51.Gao, T, Li, N, Zhang, JJ, et al. Restricted intravenous fluid regimen reduces the rate of postoperative complications and alters immunological activity of elderly patients operated for abdominal cancer: a randomized prospective clinical trail. World J Surg. 2012; 36:9931002.
52.Chau, EHL, Slinger, P. Perioperative fluid management for pulmonary resection surgery and esophagectomy. Semin Cardiothor and Vasc Anesth. 2014; 18(1):3644.
53.National Confidential Enquiry into Patient Outcome and Death. Elective and emergency surgery in elderly: an age old problem. 2010. Available from: www.ncepod.org.uk/2010report3/downloads/EESE_fullreport.pdf (Accessed July 12, 2017).
54.National Institute for Health and Care Excellence. CG 65. Inadvertent perioperative hypothermia. 2008. Available from: www.nice.org.uk/guidance/cg65 (Accessed July 12, 2017).
55.Lee, P, Mathur, PN, Colt, H. Advances in thoracoscopy: 100 years since Jacobaeus. Respiration. 2010; 79(3):177186.
56.Swanson, SJ, Meyers, BF, Gunnarson, CL, et al. Video-assisted thoracoscopic lobectomy is less costly and morbid than open lobectomy: retrospective multi-institutional database analysis. Ann Thorac Surg. 2012; 93(4):10271032.
57.Jaklitsch, MT, DeCamp, MMJ, Liptay, M, et al. Video-assisted thoracic surgery in the elderly. A review of 307 cases. Chest. 1996; 110:751758.
58.Cattaneo, SM, Park, BJ, Wilton, AS, et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008; 85:231236.
59.Wu, CY, Chen, JS, Lin, YS, et al. Feasibility and safety of nonintubated thoracoscopic lobectomy for geriatric lung cancer patients. Ann Thorac Surg. 2013; 95:405411.
60.Joshi, GP, Bonnet, F, Shah, R, et al. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia. Anesth Analg. 2008; 107:10261040.
61.Li, Y, Zhu, S, Bao, F, et al. The effects of age on the median effective concentration of ropivacaine for motor blockade after epidural anesthesia with ropivacaine. Anesth Analg. 2006; 102:18471850.
62.Hirabayashi, Y, Shimizu, R. Effect of age on extradural dose requirement in thoracic extradural anesthesia. Br J Anaesth. 1993; 71:445446.
63.Simon, MJ, Veering, BT, Stienstra, R, et al. The effects of age on neural blockade and hemodynamic changes after epidural anesthesia with ropivacaine. Anesth Analg. 2002; 94:13251330.
64.Macintyre, PE, Schug, SA, Scott, DA, et al. Acute Pain Management: Scientific Evidence, 3rd edn. Melbourne, ANZCA & FPM, 2010.
65.Warner, DO, Warmer, MA, Ritman, EL. Human chest wall function during epidural anesthesia. Anesthesiology. 1996; 85:761773.
66.Licker, MJ, Widikker, I, Robert, J, et al. Operative mortality and respiratory complications after lung resection for cancer: impact of chronic obstructive pulmonary disease and time trends. Ann Thorac Surg. 2006; 81:18301837.
67.Wink, J, Veering, BT, Aarts, L, et al. Effect of increasing age on the hemodynamic response to thoracic epidural anesthesia. Eur J Anaesthesiol. 2014; 31:597605.
68.Oka, T, Ozawa, Y, Ohkubo, Y. Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. Anesth Analg. 2001; 93:253259.
69.Guay, J. The benefits of adding epidural analgesia to general anesthesia: a metanalysis. J Anesth. 2006; 20:335340.
70.Okami, J, Higashiyama, M, Asamura, H, et al. Pulmonary resection in patients aged 80 years or over with clinical stage I NSCLC. Prognostic factors for overall survival and risk factors for postoperative complications. J Thoracic Oncol. 2009; 4:12471253.
71.Pei, G, Zhou, S, Han, Y, et al. Risk factors for postoperative complications after lung resection for non-small cell lung cancer in elderly patients at a single institution in China. J Thorac Dis. 2014; 6(9):12301238.
72.Shiono, S, Abiko, M, Sato, T. Postoperative complications in elderly patients after lung cancer surgery. Interact Cardiovasc Thoracic Surg. 2013; 16:819823.
73.Woodward, RM, Brown, ML, Stewart, ST, et al. The value of medical interventions for lung cancer in the elderly: results from SEER-CMHSF. Cancer. 2007; 110:25112518.
74.Mun, M, Kohno, T. Video assisted thoracic surgery for clinical stage I lung cancer in octogenerians. Ann Thorac Surg. 2008; 85:406411.
75.Port, JL, Mirza, FM, Lee, PC, et al. Lobectomy in octogenarians with non-small cell lung cancer: ramifications of increasing life expectancy and the benefits of minimally invasive surgery. Ann Thoracic Surg. 2011; 92(6):19511957.