Thoracic Surgery in the Elderly

  • Maria D. Castillo
  • Jeffrey Port
  • Paul M. Heerdt


As the population ages, increasing numbers of elderly patients with present for thoracic surgery. Physiologic changes that occur with advanced age result in a decline of maximal reserves, affecting the patient’s ability to cope with the stress of surgery. Increased age is also associated with increased comorbidities. Elderly patients with cancer may still stand to benefit from surgery, since survival rates for lung and esophageal cancer are very low without surgical resection. Perioperative morbidity and mortality is more closely associated with preoperative health status and tumor stage than chronological age. Minimally invasive surgical techniques such as video-assisted thoracoscopic surgery (VATS) have been shown to be an effective approach for surgical resection of cancer. Because better postoperative pulmonary function, less postoperative pain, and fewer complications were shown for patients who underwent VATS compared to those who underwent thoracotomy for lobectomy, VATS may be a good choice for patients of advanced age due to their decreased physiologic reserves. Careful preoperative assessment and postoperative care are essential in this surgical population due to their diminished ability to handle the stress of surgery.


Chronic Obstructive Pulmonary Disease Postoperative Delirium Postoperative Atrial Fibrillation Minimally Invasive Surgical Early Stage Lung Cancer 
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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Maria D. Castillo
    • 1
  • Jeffrey Port
    • 2
  • Paul M. Heerdt
    • 3
  1. 1.Department of AnesthesiologyMt. Sinai College of MedicineNew YorkUSA
  2. 2.Department of Cardiothoracic SurgeryWeill Medical College of Cornell UniversityNew YorkUSA
  3. 3.Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer CenterWeill Medical College of Cornell UniversityNew YorkUSA

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