Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases

摘要

Abstract 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 67.1 yr). Group A had 65 patients of advanced age ≥ 75 yr (range 75–87 yr; 37 men, 28 women); Group B had 222 patients aged 75 yr (range 29–74 yr; 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 ± 0.9 days compared to 4 ± 0.3 days 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.