[Preoperative management-cardiac, pulmonary, and renal dysfunction]

Surgical stress against esophageal cancer is quite heavy, because such a patient is usually old and is hyponutrionized due to inadequate peroral intake, as well as suffered from advanced stage of cancer. Thus, the patient suffering from esophageal cancer should have already various degrees of cardiac, pulmonary, or renal dysfunctions preoperatively. From this point of view, we must take care of such patients very carefully, and sometimes make a decision of the decrease of the radicality in surgery. This part describes the management of preoperative complications with cardiac, pulmonary, and renal dysfunction. Such complications must be treated before radical surgery, and be assessed by cardiologists, pulmonary physicians, and anesthesiologists.