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[目的]分析70岁以上老年人食管癌的手术适应证、围手术期并发症、死亡以及围手术期处理,探讨降低围手术期死亡的方法。[方法]回顾性分析2000年1月～2005年1月间,在我科行食管癌根治术的年龄大于70岁的185例老年食管癌患者的临床资料,采用单因素和多因素分析围手术期死亡的危险因素。[结果]全组无手术死亡,手术切除率100%。26例(14.1%)手术时间大于5h。术后并发症发生率为28.6%,围手术期死亡率为8.1%。围手术期死亡主要原因为肺部并发症、吻合口瘘和心脑血管并发症。Logistic回归分析显示术前伴发病、肺功能差、手术时间长及喉返神经损伤与围手术期死亡明显相关。[结论]70岁以上老年人食管癌术后围手术期死亡率相对较高,严格选择手术适应证和合理周密的围手术期处理对降低围手术期死亡有重要意义。
[Objective] To analyze the surgical indications, perioperative complications, death and perioperative management of esophageal cancer in the elderly over 70 years old and to explore ways to reduce the perioperative death. [Methods] The clinical data of 185 elderly patients with esophageal cancer who were over 70 years old undergoing radical resection of esophageal cancer from January 2000 to January 2005 in our department were retrospectively analyzed. Univariate and multivariate analysis of perioperative Risk factors for death. [Results] All patients died without surgery, the surgical resection rate was 100%. Twenty-six patients (14.1%) had an operation longer than 5 hours. Postoperative complications occurred in 28.6% and perioperative mortality was 8.1%. Perioperative deaths mainly due to pulmonary complications, anastomotic leakage and cardiovascular complications. Logistic regression analysis showed that preoperative complication, poor lung function, long operative time and recurrent laryngeal nerve injury were significantly associated with perioperative mortality. [Conclusion] The perioperative mortality rate of esophageal cancer patients over 70 years old is relatively high. Strict selection of surgical indications and rational perioperative management are of great significance in reducing perioperative death.