Abstract
From 1998, 61 (11%) patients aged 74 years out of 558 patients who underwent esophagectomy for thoracic esophageal cancer were studied at postoperative pulmonary complications and anastomotic leakage were more frequent in aged patients than younger patients, especially pulmonary complications (p<0.05). However, the survival curve of the aged patients was nearly equal to it that of younger patients. In the 61 aged patients, 26 patients (group R) underwent esophagectomy through right thoracotomy, 28 patients (group L) underwent it through left abdominothoracotomy; and 7 patients (group B) underwent it without thoracotomy. In group R, pulmonary complications were more common than in group L (p<0.05). While in group R 3 (11.5%) patients died in hospital due to postoperative complications, no hospital death was found in group L. Esophagectomy through left abdominothoracotomy was thought to be a safe procedure compared to esophagectomy through right thoracotomy. The 5-year survival rate of group L (58%) was better than that of group R (42%), and no patients in group B survived for 5 years. Sternotomies performed in 6 patients in the L group did not exert much effect upon the postoperative course. It was concluded that esophagectomy through left abdominothoracotomy should be come a standard operative procedure for aged patients with thoracic esophageal cancer.
