[Indication and Perioperative Management for Esophagectomy in Elderly Patients of Esophageal Cancer].

Esophagectomy is a highly invasive surgery for elderly patients. The incidence of esophageal cancer is relatively high among the aging population in Japan. Therefore, it is crucial to determine the indications for esophagectomy and implement effective pre- and post-operative management strategies, considering the reduced physical function often observed in elderly patients. In our study, approximately 20% of patients with stageⅡ/Ⅲ esophageal cancer underwent esophagectomy. When we assessed thesepatients using the estimation of physiologic ability and surgical stress (E-PASS) scoring system, we found that the E-PASS score was significantly lower in the group that underwent surgery compared to those who received chemotherapy, radiation, or palliative treatment. Evaluating the risk of esophagectomy using tools such as E-PASS or others is crucial in establishing appropriate indications and ensuring patient safety. Regarding the perioperative period, our study revealed that the complication rate did not differ significantly between patients aged 74 years or younger and those aged 75 years or older. However, patients aged 75 years or older experienced significantly longer total and post-hospital stays. This prolonged postoperative stay in elderly patients can be attributed to a decline in activities of daily living (ADL) following esophagectomy, primarily due to their lower physical function. These results emphasize the importance of considering the potential decline in ADL resulting from lower physical function in elderly patients during perioperative management. Establishing multidisciplinary perioperative teams and rehabilitation programs can enhance the quality of life for patients after esophagectomy.