Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Minimally Invasive Esophagectomy in the Elderly

Minimally Invasive Esophagectomy in the Elderly Abstract Objective 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. Methods 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. Results 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. Conclusions 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. Ultramini Abstract 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Indian Journal of Surgical Oncology Springer Journals

Minimally Invasive Esophagectomy in the Elderly

Download PDF
6 pages

Loading next page...
 
/lp/springer-journals/minimally-invasive-esophagectomy-in-the-elderly-EX65vT2Rev
Publisher
Springer Journals
Copyright
2013 Indian Association of Surgical Oncology
ISSN
0975-7651
eISSN
0976-6952
DOI
10.1007/s13193-013-0263-6
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective 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. Methods 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. Results 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. Conclusions 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. Ultramini Abstract 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.

Journal

Indian Journal of Surgical Oncology – Springer Journals

Published: Dec 1, 2013

Keywords: surgical oncology; oncology; surgery

References

  • Esophageal cancer
    PC Enzinger
  • Esophagectomy for adenocarcinoma in patients 45 years of age and younger
    J Scott Bolton
  • Improved prognosis of resected esophageal cancer
    HJ Stein, JR Siewert
  • Resection for esophageal cancer: strategies for optimal management
    A Pennathur, JD Luketich
  • Mortality and morbidity after resection for adenocarcinoma of the gastroesophageal junction: predictive factors
    A Sauvanet, C Mariette, P Thomas, P Lozac’h, P Segol, E Tiret
  • Preoperative risk analysis in patients with adenocarcinoma or squamous cell carcinoma of the oesophagus
    E Bollschweiler
  • Predictors of operative death after oesophagectomy for carcinoma
    H Abunasra, S Lewis, L Beggs, J Duffy, D Beggs, E Morgan
  • Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients
    JY Ma, Z Wu, Y Wang, YF Zhao, LX Liu, YL Kou
  • Mortality increases for octogenarians undergoing esophagogastrectomy for esophageal cancer
    AH Moskovitz, NP Rizk, E Venkatraman, MS Bains, RM Flores, BJ Park
  • Esophagectomy for carcinoma of the esophagus in the elderly: results of current surgical management
    RT Poon, SY Law, KM Chu, FJ Branicki, J Wong
  • Esophageal resection for carcinoma in patients older than 70 years
    MS Sabel, JL Smith, HR Nava, K Mollen, HO Douglass, JF Gibbs
  • Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years
    E Internullo, J Moons, P Nafteux, W Coosemans, G Decker, LP De
  • The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection
    CG Peyre, JA Hagen, SR DeMeester, NK Altorki, E Ancona, SM Griffin
  • Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: Impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma
    T Lerut, P Nafteux, J Moons, W Coosemans, G Decker, P Leyn
  • Transhiatal esophagectomy in a high volume institution
    AR Davies, MJ Forshaw, AA Khan, AS Noorani, VM Patel, DC Strauss
  • Outcomes after esophagectomy: A ten year retrospective cohort
    SH Bailey, DA Bull
  • Transhiatal approach for esophagectomy
    EA Ferreira
  • Oesophagectomy by a transhiatal approach or thoracotomy: A prospective randomized trial
    M Goldminc, G Maddern, E LePrise
  • Thoracoscopic subtotal oesophagectomy
    A Cuschieri
  • AJCC cancer staging manual
    citation_title=AJCC cancer staging manual; citation_publication_date=
  • Outcome of esophagectoy for cancer in elderly patients
    TM Cijs, C Verhoef, EW Steyerberg, LB Koppert, TC Khe Tran, BPL Wijnhoven, HW Tilanus, J Jonge
  • Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients
    JY Ma, Z Wu, Y Wang, YF Zhao, LX Liu, YL Kou, QH Zhou
  • Results of esophagectomy for esophageal cancer in elderly patients: age has little influence on outcome and survival
    A Ruol, G Portale, G Zaninotto, M Cagol, F Cavallin, C Castoro
  • Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years
    E Internullo, J Moons, P Nafteux, W Coosemans, G Decker, LP De
  • Extended esophagectomy in elderly patients with esophageal cancer: Minor effect of age alone in determining the postoperative course and survival
    BB Pultrum, DJ Bosch, MW Nijsten, MG Rodgers, H Groen, JP Slaets, JT Plukker
  • Minimally invasive esophagectomy in the elderly
    Y Perry, HC Fernando, PO Buenaventura, NA Christie, JD Luketich
  • The experience of a single institution with 112 consecutive patients. Surg Endosc. 2010 Mar 5.
    Puntambekar SP, Agarwal GA, Joshi SN, Rayate NV, Sathe RM, Patil AM. Thoracolaparoscopy in the lateral position for esophageal cancer
  • Endoscopic oesophagectomy through a right thoracoscopic approach
    A Cuschieri, S Shimi, S Banting
  • Radical thoracoscopic esophagectomy for cancer
    SP Dexter, IG Martin, MJ McMahon
  • Thoracoscopic mobilization of the esophagus. A 6 year experience
    BM Smithers, DC Gotley, D McEwan, I Martin, J Bessell, L Doyle
  • Thoracoscopic esophagectomy for esophageal cancer
    S Law, M Fok, KM Chu, J Wong
  • Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy
    NT Nguyen, DM Follette, BM Wolfe, PD Schneider, P Roberts, JE Goodnight
  • Open versus minimally invasive esophagectomy: Trends of utilization and associated outcomes in England
    AI Lazzarino, K Nagpal, A Bottle
  • Oncologic efficacy is not compromised, and may be improved with minimally invasive esophagectomy
    AC Berger, A Bloomenthal, B Weksler
  • Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma
    SJ Swanson, HF Batirel, R Bueno
  • Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor-Lewis esophagectomy
    TH Pham, KA Perry, JP Dolan
  • Systematic review of minimally invasive resection for gastro-oesophageal cancer
    EH Gemmill, P McCulloch
  • Minimally invasive esophagectomy for cancer
    G Decker, W Coosemans, P Leyn, H Decaluwé, P Nafteux, D Raemdonck, T Lerut
  • Outcomes after minimally invasive esophagectomy, review of over 1000 patients
    JD Luketich, A Pennathur, O Awais
  • Short-Term Outcomes Following Open Versus Minimally Invasive Esophagectomy for Cancer in England, A Population-Based National Study
    R Mamidanna, A Bottle, P Aylin
  • Prognostic impact of postoperative radiation in patients undergoing radical esophagectomy for pathologic lymph node positive esophageal cancer
    X Yaping, L Jinshi, D Xianghui, S Xiaojiang, Z Yuanda, C Jianxiang, L Bo, L Wei, J Hao, M Weimin