title: 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.
  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.
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Puntambekar
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Kenawadekar
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Archit
authors.initials: A
authors.lastname: Pandit
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Nadkarni
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Agarwal
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Nasir Ahmad
authors.initials: NA
authors.lastname: Bhat
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Jainul
authors.initials: J
authors.lastname: Malik
authors.affiliation: Department of Minimal Access Surgery, Galaxy Care Laparoscopic Institute, Karve Road, Pune, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Reddy
keywords: Elderly; Esopphageal cancer; Laparoscopy; Minimal invasive esophagectomy; Thoracosopy