Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1989 Feb;44(2):141–145. doi: 10.1136/thx.44.2.141

Oesophagogastrectomy in patients over 70.

D D Muehrcke 1, D K Kaplan 1, R J Donnelly 1
PMCID: PMC461720  PMID: 2928999

Abstract

Although the results of oesophageal resection for benign and malignant disease are well documented, the risk of operative death and long term survival in patients over the age of 70 is not well defined. The outcome has been reviewed for 46 patients (23 male, 23 female) aged 70 years or more (mean 74 years) undergoing oesophageal resection during a period of seven years; 16 patients were 75 years or over. All resections were performed with the EEA stapler, except for one cervical anastomosis that was stitched by hand. In 42 patients resection was for malignancy. Six patients died within 30 days of operation or during the initial hospital stay, giving an operative mortality of 13%. Only one of the 16 patients aged 75 years or more died. Cardiopulmonary complications accounted for most of the operative deaths. Patients were scored retrospectively by a multifactual risk factor. Patients who left hospital had a mean preoperative score of 3.66, compared with 15.2 for those who died. Use of such a score may help to improve selection for surgery in this age group. It is concluded that oesophagogastrectomy may be performed in selected patients over the age of 70 years with acceptable mortality, morbidity, and length of hospital stay.

Full text

PDF
144

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akiyama H., Tsurumaru M., Kawamura T., Ono Y. Principles of surgical treatment for carcinoma of the esophagus: analysis of lymph node involvement. Ann Surg. 1981 Oct;194(4):438–446. doi: 10.1097/00000658-198110000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Anderson R. P., Bonchek L. I., Grunkemeier G. L., Lambert L. E., Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res. 1974 Mar;16(3):224–230. doi: 10.1016/0022-4804(74)90035-3. [DOI] [PubMed] [Google Scholar]
  3. Angorn I. B., Hegarty M. M. Palliative pulsion intubation in oesophageal carcinoma. Ann R Coll Surg Engl. 1979 May;61(3):212–214. [PMC free article] [PubMed] [Google Scholar]
  4. Behl P. R., Holden M. P., Brown A. H. Three years' experience with esophageal stapling device. Ann Surg. 1983 Aug;198(2):134–136. doi: 10.1097/00000658-198308000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Belsey R., Hiebert C. A. An exclusive right thoracic approach for cancer of the middle third of the esophagus. Ann Thorac Surg. 1974 Jul;18(1):1–15. doi: 10.1016/s0003-4975(10)65712-8. [DOI] [PubMed] [Google Scholar]
  6. CELESTIN L. R. Permanent intubation in inoperable cancer of the oesophagus and cardia: a new tube. Ann R Coll Surg Engl. 1959 Aug-Sep;25:165–170. [PMC free article] [PubMed] [Google Scholar]
  7. Donnelly R. J., Sastry M. R., Wright C. D. Oesophagogastrectomy using the end to end anastomotic stapler: results of the first 100 patients. Thorax. 1985 Dec;40(12):958–959. doi: 10.1136/thx.40.12.958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Earlam R., Cunha-Melo J. R. Oesophageal squamous cell carcinoma: I. A critical review of surgery. Br J Surg. 1980 Jun;67(6):381–390. doi: 10.1002/bjs.1800670602. [DOI] [PubMed] [Google Scholar]
  9. Earlam R., Cunha-Melo J. R. Oesophogeal squamous cell carcinoms: II. A critical view of radiotherapy. Br J Surg. 1980 Jul;67(7):457–461. doi: 10.1002/bjs.1800670702. [DOI] [PubMed] [Google Scholar]
  10. Ellis F. H., Jr, Gibb S. P. Esophagogastrectomy for carcinoma: current hospital mortality and morbidity rates. Ann Surg. 1979 Dec;190(6):699–705. doi: 10.1097/00000658-197912000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fabri B., Donnelly R. J. Oesophagogastrectomy using the end-to-end anastomosing stapler. Thorax. 1982 Apr;37(4):296–299. doi: 10.1136/thx.37.4.296. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Girardet R. E., Ransdell H. T., Jr, Wheat M. W., Jr Palliative intubation in the management of esophageal carcinoma. Ann Thorac Surg. 1974 Oct;18(4):417–430. doi: 10.1016/s0003-4975(10)64380-9. [DOI] [PubMed] [Google Scholar]
  13. Goldman L., Caldera D. L., Nussbaum S. R., Southwick F. S., Krogstad D., Murray B., Burke D. S., O'Malley T. A., Goroll A. H., Caplan C. H. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977 Oct 20;297(16):845–850. doi: 10.1056/NEJM197710202971601. [DOI] [PubMed] [Google Scholar]
  14. Gunnlaugsson G. H., Wychulis A. R., Roland C., Ellis F. H., Jr Analysis of the records of 1,657 patients with carcinoma of the esophagus and cardia of the stomach. Surg Gynecol Obstet. 1970 Jun;130(6):997–1005. [PubMed] [Google Scholar]
  15. Kaplan D. K., Whyte R. I., Donnelly R. J. Oesophagogastrectomy using stapling instruments. Eur J Cardiothorac Surg. 1988;2(2):95–99. doi: 10.1016/s1010-7940(88)80005-8. [DOI] [PubMed] [Google Scholar]
  16. Keeling P., Gillen P., Hennessy T. P. Oesophageal resection in the elderly. Ann R Coll Surg Engl. 1988 Jan;70(1):34–37. [PMC free article] [PubMed] [Google Scholar]
  17. Mohansingh M. P. Mortality of oesophagal surgery in the elderly. Br J Surg. 1976 Aug;63(8):579–580. doi: 10.1002/bjs.1800630804. [DOI] [PubMed] [Google Scholar]
  18. Pearson J. G. The radiotherapy of carcinoma of the oesophagus and post cricoid region in south east Scotland. Clin Radiol. 1966 Jul;17(3):242–257. doi: 10.1016/s0009-9260(66)80030-2. [DOI] [PubMed] [Google Scholar]
  19. Procter D. S. Esophageal intubation for carcinoma of the esophagus. World J Surg. 1980 Jul;4(4):451–461. doi: 10.1007/BF02393173. [DOI] [PubMed] [Google Scholar]
  20. Sanfelippo P. M., Bernatz P. E. Celestin-tube palliation for malignant esophageal obstruction. Surg Clin North Am. 1973 Aug;53(4):921–926. doi: 10.1016/s0039-6109(16)40097-6. [DOI] [PubMed] [Google Scholar]
  21. Sugimachi K., Matsuzaki K., Matsuura H., Kuwano H., Ueo H., Inokuchi K. Evaluation of surgical treatment of carcinoma of the oesophagus in the elderly: 20 years' experience. Br J Surg. 1985 Jan;72(1):28–30. doi: 10.1002/bjs.1800720113. [DOI] [PubMed] [Google Scholar]
  22. Unruh H. W., Pagliero K. M. Pulsion intubation versus traction intubation for obstructing carcinomas of the esophagus. Ann Thorac Surg. 1985 Oct;40(4):337–342. doi: 10.1016/s0003-4975(10)60063-x. [DOI] [PubMed] [Google Scholar]
  23. Watson A. A study of the quality and duration of survival following resection, endoscopic intubation and surgical intubation in oesophageal carcinoma. Br J Surg. 1982 Oct;69(10):585–588. doi: 10.1002/bjs.1800691009. [DOI] [PubMed] [Google Scholar]
  24. Wong J. Management of carcinoma of oesophagus: art or science? J R Coll Surg Edinb. 1981 May;26(3):138–149. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES