Purpose: Lung cancer is one of the major sources of mortality in the elderly. This study was undertaken to assess the early and long-term results of surgical resection in patients older than 70 years of age by comparing the results of patients aged 70–79 years (group 1) with patients older than 80 years of age (group 2). Methods: Data on patient age, gender, spirometry values, side, size, histology and stage of the tumor, surgical procedures, postoperative complications, Charlson comorbidity scores (CCS), and survival were collected. Results: After 1–2 propensity score matching group 1 (70–79 years) included 84 and group 2 (age over 80) 42 cases. The multivariate analysis showed that CCS was the only significant factor affecting the development of complications (p = 0.003). The overall median and 5-year survival of all patients were 55 months and 42.5%, respectively. Although the survival of the elderly group 2 was higher than the first group, the difference did not reach significance (50 vs. 49 months, respectively). Conclusion: The outcomes of surgery in terms of morbidity and mortality rates do not differ between the two age groups. The safety of pulmonary resections in the elderly group is comparable to patients under 70 years if the comorbidities are appropriately controlled. In addition, surgery provides satisfactory survival rates in both age groups.

Background: The aim of this study was to assess the relationship between Glasgow Prognosis Score (GPS) and survival in patients who underwent pneumonectomy due to pN2 non-small cell lung cancer (NSCLC). Materials and Methods: A total of 45 patients who were determined to have pN2 disease after pneumonectomy between 2007 and 2016 were retrospectively analyzed. The patients were assigned a GPS between 0 and 2 as follows: elevated CRP level (>1.0 mg/dL) and hypoalbuminemia (<35 mg/dL) was classified as GPS 2, elevated CRP but albumin >35 mg/dL was classified as GPS 1, and CRP <1.0 mg/dl and albumin >35 mg/dL were classified as GPS 0. Results: Of the 45 patients included in the study, 42 (93.3%) were male and 3 (6.7%) were female. Eighteen (40%) of the patients had adenocarcinoma and 27 (60%) had squamous cell carcinoma. Skip pN2 (pN0N2) was detected in 10 patients. Mean follow-up time was 28 months. The 5-year survival rate was 40.2%. The main prognostic factors associated with survival were GPS and adjuvant therapy (p = 0.023, p = 0.001). Conclusions: In this study, there was no relationship between N1 status and survival in pneumonectomy patients with pN2 NSCLC, whereas GPS score and adjuvant therapy were found to be prognostically significant in terms of survival.

To cite this article: Ceritoğlu A, Sezen CB, Aker C, Girgin O, Akın H. Prognostic factors associated with morbidity and mortality after surgery for postintubation tracheal stenosis. Curr Thorac Surg 2020; 5(1): 16-22. ABSTRACT Background:In this study, we reviewed the treatment, follow-up, and prognostic factors associated with complications in patients who underwent tracheal resection due to postintubation tracheal stenosis (PETS), in light of the literature. Materials and Methods: Twenty-five patients who were operated for PETS between June 2012 and June 2017 were retrospectively evaluated. The patients' postoperative complications and prognostic factors affecting mortality were examined.Results: There was 11 female (44%) and 14 male (56%) patients. Eight patients (32%) had comorbidities.The mean prolonged intubation time was 47.4 ± 55.0 minutes. Eight patients (32%) developed postoperative morbidity. The main prognostic factors associated with morbidity were the length of the stenotic area and the presence of endocrine and respiratory comorbidities (p<0.05). Tracheal fistulae were observed in 2 patients. The postoperative mortality rate was 8% (n=2). One patient with fistula died on postoperative day 2, while another patient died at postoperative three months due to cardiac failure. No significant factor was identified in relation to the development of tracheal fistulae. Conclusions:The most important factor associated with complications was the presence of endocrine comorbidities. Although tracheal surgery results in high rates of postoperative morbidity and mortality, we believe these risks can be reduced by experienced surgeons and appropriate patient selection.

Background: Pulmonary sequestration is defined as nonfunctional lung tissue without a normal tracheobronchial tree that is supplied by an aberrant systemic artery. The awareness of the preoperative diagnosis could be very crucial for the safety of the operation. Materials and Methods: We retrospectively reviewed the records of 16 patients who underwent resection for pulmonary sequestration between 2006-2016. Nine of 16 cases (56%) were female, and the mean age of the patients was 38.5 ± 9.9 years. Fiberoptic bronchoscopy and standard computed thorax tomography were performed for diagnostic work-up in all cases. The patients were divided into 2 groups based on the presence (Group A) or abscence (Group B) of the preoperative diagnosis. Results: The most common presenting symptoms were cough and expectoration. Preoperative diagnosis of the sequestration was obtained in only 5 patients (31%). Bronchiectasis was the most common cause of false diagnosis, followed by hydatid disease, malignancy, and aspergillosis. Left-sided and intrapulmonary locations were dominant with 12 (75%) and 13 (81%) cases, respectively. Lobectomy was the most common type of surgical resection (75%) and thoracic aorta was the source of aberrant artery in 87% of the patients. Patients in group A were younger. Though intralobar and extralobar types were equally distributed in both groups, all cases in group B had intralobar type. The mean operation time, blood loss, the amount of drainage, and the hospital stay were all insignificantly longer in group B patients. Five of the 6 morbidities occured in group B patients, but the difference was not statistically significant. No mortality occured. Conclusions: Surgical resection provides definitive management, and is usually reserved for the patients with symptoms. Facilities for a definitive diagnosis should be performed in every case, because, although insignificant, the rate of morbidity is higher in the patients without a definitive diagnosis. Further studies concerning of more patients are required to obtain more comprehensive results.

No abstract