Symposium 1:Pathophysiology of the hypopharynx and esophagus in the geriatric age group. A. Surgical treatment for the aged patients with cancer of the thoracic esophagus.

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Resectability rate of the aged patients (≥ age of 72) with cancer of the thoracic esophagus in recent ten years (1980-89) increased to 70.5%, as compared with resectability in former ten years (1970-79) of 51.5%. This increase of resectability was attributable to the improvement of the perioperative management such as cardiorespiratory and nutritional supports. Assessing the operability of the aged patients, physiological age, which is based on the reserve function of the vital organ such as heart, lung, liver and kidney, rather than calendar age should be considered.<BR>As a surgical strategy for the aged patients with cancer of the thoracic esophagus, who are assessed not to be indicated to the standard thoracotomy and laparotomy, transhiatal esophagectomy without thoracotomy is useful, even if palliative surgery. Based on this strategy, eight aged cases underwent transhiatal esophagectomy without thoracotomy, and three cases survived more than three years.<BR>There is no significant difference of long term survival between the aged patients and over all cases.
特定非営利活動法人日本気管食道科学会の論文