386. SURGICAL SHORT-OUTCOMES IN ELDERLY PATIENTS WITH ESOPHAGEAL CANCER IN OUR INSTITUTION

Abstract

Abstract With aging, patients with esophageal cancer would have several comobidity and decline of physiological function. It is difficult to fit the standerd treatment to the elderly patients with esopageal camcer. We review the data of elderly patients who underwent operation for esopageal cancer in our institution to evaluate the safety of surgery in this partucular population. During January 2017 and December 2021, twenty three patients over 75-year-old underwent the operation with right thoracotomy, that is McKeown’s or Ivor-Lewis operation, for esophageal cancer or esophago-gastric junction cancer in our institution. We retrospectively analyzed their preoperative assessment, concurrent disorders, surgical techniques used, postoperative course, and complications. Average age of the patients was 79.5 years, and over 80 year-old patients were nine. Preoperative chemotherapy was done in 12 cases. Only 3 patients underwent esophagectomy with right thoracotomy and three-field lymph node dissection. Postoperative complications occurred in 17 patients (74%). Mortality was one cases, because of severe respiratory failure. Anastomotic leakage was observed in nine patients. As other complications over Grade II in Clavien-Dindo (CD) classification, anastomotic stricture was 4, pneumonia was 3 cases. Recurrent nerve paralysis was observed in 6 patients in Grade I in CD classification. It is difficult to decide treatment for esophageal cancer only at age. In elderly cases, it would require more ingenuity for anastomosis after esophagectomy.