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Minimally invasive esophagectomy in the elderly
Yaron Perry1, Hiran C Fernando, Percival O Buenaventura
1Division of Thoracic and Foregut Surgery and The Minimally Invasive Surgery Center University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|December 26, 2002
Summary
Minimally invasive esophagectomy (MIE) in elderly patients demonstrated acceptable morbidity and low mortality. This approach offers a reduced hospital stay compared to traditional methods, making it a viable option for older individuals.
Area of Science:
- Thoracic Surgery
- Geriatric Surgery
- Surgical Oncology
Background:
- Increasing numbers of elderly patients are undergoing esophagectomy.
- Morbidity and mortality rates in this demographic are not well-defined.
- Minimally invasive esophagectomy (MIE) may reduce procedure-related complications.
Purpose of the Study:
- To summarize the experience with MIE in elderly patients.
- To evaluate the safety and efficacy of MIE in patients aged 75 and older.
Main Methods:
- Retrospective review of 41 patients aged 75 years or older who underwent MIE.
- Patients had various esophageal conditions including adenocarcinoma, squamous cell carcinoma, and Barrett's esophagus with high-grade dysplasia.
- Data collected included patient demographics, procedure details, ICU and hospital stay, and complications.
Main Results:
- MIE was successfully performed in all 41 elderly patients without open conversion.
- Median ICU stay was 1 day and median hospital stay was 7 days.
- Major morbidity occurred in 19% of patients, with no perioperative mortality.
Conclusions:
- MIE is a safe and effective procedure for elderly patients undergoing esophagectomy.
- It is associated with acceptable morbidity, low mortality, and shorter hospital stays.
- MIE represents a valuable option for managing esophageal diseases in the geriatric population.
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