Minimally invasive esophagectomy in the elderly.
OBJECTIVE
In recent years, older patients are being referred for esophagectomy, and the associated morbidity and mortality is not well defined. Advances in minimally invasive techniques now allow minimally invasive esophagectomy (MIE) to be performed that may minimize the morbidity of this procedure. The objective of this report was to summarize our experience with MIE in the elderly.


METHODS
From February 1997 through February 2001, 41 patients (14 women, 27 men) 75 years of age or older (mean age 78, range 75 to 89) underwent esophagectomy (28 for adenocarcinoma, 7 squamous, 6 Barrett's with high-grade dysplasia).


RESULTS
Esophagectomy was performed in a minimally invasive fashion in 41 patients. No open conversions were necessary. The median ICU stay was 1 day (range 1 to 34). The median hospital stay was 7 days (range 5 to 50). Major morbidity occurred in 19% of the cases and included 1 persistent air leak, 1 case of pneumonia with acute respiratory failure, 1 tracheal tear, 1 chylothorax, and 1 myocardial infarction. Three anastomotic leaks and 1 small bowel perforation occurred. All were recognized early and treated surgically. No perioperative mortalities took place.


CONCLUSIONS
In our center, MIE was performed in elderly patients with an acceptable morbidity, low mortality, and reduced length of hospital stay compared with that in previous reports.
Perry
Yaron
Y
Division of Thoracic and Foregut Surgery and The Minimally Invasive Surgery Center University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Fernando
Hiran C
HC
Buenaventura
Percival O
PO
Christie
Neil A
NA
Luketich
James D
JD
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009017:Morbidity; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*