[Surgery for cancer of the esophagus in elderly patients]

Esophageal cancer has a fulminant biological characteristic, and shows a higher rate of lymph node metastasis than other gastrointestinal malignancies. The distribution of lymphatic spread is wide from cervical to abdominal field, and 3-field lymph node dissection is a standard procedure in esophageal cancer surgery. However, the morbidity and mortality rate following esophageal resection is higher than that of other gastrointestinal or thoracic surgery. The most serious postoperative complication of esophageal surgery in elderly patients is a pulmonary problem. In order to reduce postoperative pulmonary complications, we try to preserve bronchial artery, pulmonary branches of the vagal nerve, in addition to definite preservation of bilateral recurrent laryngeal nerve. Our survival rate and mean survival period in elderly patients with esophageal cancer was fairly good. To achieve a high survival rate and reduce postoperative morbidity and mortality in elderly patients, preoperative assessment of pulmonary function and quality control of surgical procedure is essential.