Puntambekar Shailesh, Kenawadekar Rahul, Pandit Archit, Nadkarni Akshay, Joshi Saurabh, Agarwal Geetanjali, Bhat Nasir Ahmad, Malik Jainul, Reddy Sunil
Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
Indian J Surg Oncol. 2013 Dec;4(4):326-31. doi: 10.1007/s13193-013-0263-6. Epub 2013 Aug 24.
A retrospective analysis of a prospectively maintained database to evaluate our experience in elderly patients (>70 years) undergoing Thoracolaparoscopic esophagectomy for cancer oesophagus. To ascertain whether age, is a limiting factor for patients undergoing minimally invasive esophagectomy.
All Patients above 70 years of age, referred to the Gastro-esophageal clinic were included in the study. Tumours were staged as per AJCC 6th ed. 2002. Patients diagnosed with T1/2/3, N0/1 lesion of the mid/lower oesophagus (Infra Azygous) and type I and II Gastro esophageal junction tumours were included in the study. Patients with ASA grade IV were excluded. All patients who underwent Thoracolaparoscopic esophagectomy from January 2009 till January 2012 were evaluated for their perioperative outcomes.
Sixty eight patients underwent Minimal Invasive esophagectomy from January 2009 to January 2012. There were 45 males and 23 females. The average age in elderly group was 75.76 ± 5.96 years (range 70 to 91). Mean operative time was 178.84 ± 65.26 min, mean blood loss 143.84 ml(range 32-450 ml), mean ICU stay 3.84 days(range 2-11 days) and mean hospital stay was 12.76 days(range 8-21 days). Pneumonia and Cardiac related complications occurred in 10.30 % and 1.47 % patients respectively. None of the procedures required conversion to open thoracotomy.
Thoracolaparoscopic esophagectomy is feasible and surgically safe in elderly patients with low morbidity and mortality. Thus age of a patient should not be considered a limiting factor.
This is an original article about our experience of thoracolaparoscopic esophagectomy for cancer esophagus in elderly patients. After analyzing the data we feel that age of the patient cannot be a truly limiting factor for patient diagnosed of esophageal cancer to undergo minimally invasive esophagectomy.
对一个前瞻性维护的数据库进行回顾性分析，以评估我们在老年患者（>70岁）中进行胸腹腔镜联合食管癌切除术的经验。确定年龄是否是接受微创食管癌切除术患者的限制因素。
纳入所有转诊至胃食管诊所的70岁以上患者。肿瘤根据2002年美国癌症联合委员会（AJCC）第6版进行分期。研究纳入诊断为中/下段食管（奇静脉以下）T1/2/3、N0/1病变以及I型和II型胃食管交界肿瘤的患者。排除美国麻醉医师协会（ASA）分级为IV级的患者。对2009年1月至2012年1月期间所有接受胸腹腔镜联合食管癌切除术的患者的围手术期结果进行评估。
2009年1月至2012年1月期间，68例患者接受了微创食管癌切除术。其中男性45例，女性23例。老年组的平均年龄为75.76±5.96岁（范围70至91岁）。平均手术时间为178.84±65.26分钟，平均失血量为143.84毫升（范围32 - 450毫升）；平均重症监护病房（ICU）停留时间为3.84天（范围2 - 11天），平均住院时间为12.76天（范围8 - 21天）。肺炎和心脏相关并发症分别发生在10.30%和1.47%的患者中。所有手术均无需转为开胸手术。
胸腹腔镜联合食管癌切除术在老年患者中是可行的，手术安全性高，发病率和死亡率低。因此，患者年龄不应被视为限制因素。
这是一篇关于我们在老年患者中进行胸腹腔镜联合食管癌切除术经验的原创文章。分析数据后，我们认为患者年龄不应成为诊断为食管癌的患者接受微创食管癌切除术的真正限制因素。
