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Cardiopulmonary function in lung resection performed for bronchogenic cancer in patients above 65 years of age.

The authors present an account of the preoperative cardiopulmonary examination and on postoperative changes in 77 patients with bronchogenic cancer subjected to radical surgical treatment. Twenty-three of them were older than 65 years. The results of ventilation tests do not differ significantly from those in younger patients; the older patients show only a tendency to higher residual volume and a less favourable ratio between alveolar and total ventilation than younger individuals. In the blood gases and hemodynamic values no significant differences were revealed. The mortality during the initial postoperative period and within six months after operation is not higher in patients over 65 years that in the other groups. The postoperative changes are approximately equal in all age groups. In the older patients only the mean pressure in the right atrium and in pulmonary artery as well as the total pulmonary resistance rise more than in younger cases. No case of respiratory acidosis or right heart failure was recorded.The authors conclude that the age of the patients is not decisive for the indication of radical surgical therapy of bronchogenic cancer and only the preoperative assessement of cardiopulmonary function is important, whereby in older age groups an approximately equal development of postoperative functional changes as in younger groups may be expected.Relative contraindications of more extensive lung resections for bronchogenic cancer include also the advanced age of the patients. The conception of advanced age is, however, usually not specified; the majority of authors agree that the decisive criterion for surgical therapy is the cardiopulmonary function and not advanced age alone. Nevertheless, many authors are rather reserved concerning indication in patients 60-70 years of age.