Xing Wenqun, Liu Xianben, Miao Peng, Hao Wentao, Li Keting, Wang Hao, Zheng Yan
Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
Department of Thoracic Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2023 May 18;13:1144047. doi: 10.3389/fonc.2023.1144047. eCollection 2023.
For elderly patients aged ≥75 with esophageal cancer, whether surgical treatment is safe and effective and whether it is feasible to use a relatively radical "no tube, no fasting" fast-track recovery protocol remain topics of debate. We conducted a retrospective analysis to shed light on these two questions.
We retrospectively collected the data of patients who underwent McKeown minimally invasive esophagectomy (MIE) combined with early oral feeding (EOF) on postoperative day 1 between April 2015 and December 2017 at Medical Group 1, Ward 1, Department of Thoracic Surgery of our hospital. Preoperative characteristics, postoperative complications, operation time, intraoperative blood loss, duration of anastomotic leakage (day), hospital stay, and survival were evaluated.
Twenty-three elderly patients with esophageal cancer underwent surgery with EOF. No significant difference was observed in intraoperative measures. The incidence of postoperative complications was 34.8% (8/23). Two patients (8.7%) were terminated early during the analysis of the feasibility of EOF. For all 23 patients, the mean hospital stay was 11.4 (5-42) days, and the median survival was 51 months.
Patients aged ≥75 with resectable esophageal cancer can achieve long-term survival with active surgical treatment. Moreover, the "no tube, no fasting" fast-track recovery protocol is safe and feasible for elderly patients.
对于年龄≥75岁的老年食管癌患者，手术治疗是否安全有效，以及采用相对激进的“无管、无禁食”快速康复方案是否可行，仍是存在争议的话题。我们进行了一项回顾性分析以阐明这两个问题。
我们回顾性收集了2015年4月至2017年12月在我院胸外科1病区1医疗组接受麦克尤恩微创食管切除术（MIE）并于术后第1天开始早期经口进食（EOF）的患者的数据。评估术前特征、术后并发症、手术时间、术中失血、吻合口漏持续时间（天）、住院时间和生存率。
23例老年食管癌患者接受了EOF手术。术中指标未观察到显著差异。术后并发症发生率为34.8%（8/23）。在分析EOF可行性期间，有2例患者（8.7%）提前终止。对于所有23例患者，平均住院时间为11.4（5 - 42）天，中位生存期为51个月。
年龄≥75岁的可切除食管癌患者通过积极的手术治疗可实现长期生存。此外，“无管、无禁食”快速康复方案对老年患者是安全可行的。
