雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Esophagectomy and Perioperative Management in Elderly Patients with Esophageal Cancer Masayuki Watanabe 1 , Ryotaro Kozuki 1 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research Keyword: esophageal cancer , elderly , comorbidity pp.870-875
Published Date 2020/9/20
DOI https://doi.org/10.15106/j_kyobu73_870
  • Abstract
  • Look Inside
  • Reference

According to the aging of society, elderly patients with esophageal cancer have been increasing in Japan. A multimodality treatment strategy is required to achieve long-term survival in patients with advanced-stage esophageal cancer. However, in elderly patients with impaired organ functions, the highly invasive treatment strategy is often difficult to be indicated. Esophagectomy remains the mainstay of treatment even in the elderly. Indication for esophagectomy in the elderly should be determined comprehensively, based on the physical status, life expectancy, tumor staging, and patients’ desires. To predict the risk of postoperative complications, some scoring systems, such as estimation of physiology ability and surgical stress (E-PASS) and controlling nutritional status (CONUT), and the risk calculator provided by the National Clinical Database in Japan should be appropriately used. For patients with impaired organ functions, surgical procedures to reduce the surgical invasiveness, such as 2-stage operation, transhiatal esophagectomy, and mediastinoscopic esophagectomy, should be considered as an alternative to conventional transthoracic esophagectomy and reconstruction. Depending on the situations, preservation of the bronchial artery, thoracic duct, and azygos arch should be considered. A care bundle by a multidisciplinary perioperative management team may decrease postoperative morbidity and mortality rates in elderly patients undergoing esophagectomy.


© Nankodo Co., Ltd., 2020

基本情報

電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

関連文献

もっと見る

文献を共有