PURPOSE: Video-assisted thoracoscopic surgery has widely recognized as a less invasive surgical therapy for a lung cancer. The purpose of this study was to determine whether thoracoscopic lung resections for lung cancer using a pre-emptive analgesia would be performed safely and completely in over 80 year-old patients.
METHODS: From November 2000 to April 2008, 43 patients over 80 years old with non-small cell lung cancer have been thoracoscopically operated on using a pre-emptive analgesia. As a pre-emptive analgesia, we used pre-operative epidural anesthesia, and a intercostals nerve block and subcutaneous local anesthesia in the end of the operation. 43 patients, 80 to 88 years of age (mean 82.0), underwent 14 lobectomy (with a mediastinal lymphnode resection in 5), 7 segmentectomy, 22 wedge resection.
RESULTS: There is no operative mortality and all patients but two were alive (two patient died of cancer). Post-operative complications were few (atelectasis 2, air leakage 2). Visual analogue scales at post operative periods revealed low points (VAS in one Post Operative Day; 1.2 at rest, 2.2 at coughing 3, two POD; 1.5 at rest, 2.6 at coughing, seven POD; 0.7 at rest, 1.3 at coughing).
CONCLUSION: Video-assisted thoracoscopic lung resections using a pre-emptive analgesia for lung cancer patients over 80 years or more is considered to offer an acceptable clinical outcome.
CLINICAL IMPLICATIONS: Video-assisted thoracoscopic lung resections using a pre-emptive analgesia for lung cancer patients over 80 years or more is considered to offer an acceptable clinical outcome.
DISCLOSURE: Takashi Tojo, No Financial Disclosure Information; No Product/Research Disclosure Information