Surgery for esophageal squamous cell carcinoma(ESCC) is one of the most invasive surgery and high mortality rate because operation is centered on the thoracic cavity. Recently, Japan has been facing aging society, and surgery for elderly ESCC patient is increasing. In our hospital, we changed surgical position from left lateral position to prone. In this study, we investigated the surgical outcome and prognosis of ESCC operation in the patients aged ≧ 75. Methods From April 2011 to March 2019, 39 ESCC operations for patients aged ≧ 75 were performed in our hospital. We compered surgical position. We retrospectively examined clinicopathological factors, long-term prognosis, preoperative nutritional status (albmin, neutrophil and lymphocyte ratio), and operation factors (operation time, blood loss, recurrent nerve paralysis, complication, hospital stay). Results Cases in lateral position surgery were 22 and prone position were 17. The median age was 79 vs 79 years old, and the gender ratio was male: female = 16:6/14:3. No significant differences were observed in preoperative nutritional status. The operation time was 458 min vs 501 min (p = 0.126). The blood loss was 318 mL vs 195 mL (p = 0.003). The rate of recurrent nerve paralysis was 42.1% vs 29.4% (p = 0.262). The number of patients in Clavien-Dindo ≧ III complications was 40.9% vs 41.2% (p = 0.987). 3-year OS was 74.7% vs 77.3%, DFS was 78.6% vs 67.7%. Conclusion In ESCC patients aged ≧ 75, surgery in prone position was relatively safe. The blood loss and the recurrent nerve paralysis ware tend to be less. Recurrent nerve monitoring during operation and evaluation of perioperative swallowing function seemed to be the next subject.

中文翻译：

---

212 内镜食管切除术在 75 岁以上老年患者俯卧位的应用

食管鳞状细胞癌（ESCC）的手术是侵入性最强的手术之一，手术以胸腔为中心，死亡率高。近年来，日本面临老龄化社会，老年ESCC患者的手术日益增多。在我们医院，我们将手术体位从左侧卧位改为俯卧位。在本研究中，我们调查了≥75岁患者ESCC手术的手术结果和预后。方法2011年4月至2019年3月，我院为≥75岁患者进行了39例ESCC手术。我们计算了手术位置。我们回顾性研究了临床病理因素、远期预后、术前营养状况（白蛋白、中性粒细胞和淋巴细胞比值）和手术因素（手术时间、失血量、复发性神经麻痹、并发症、住院）。结果侧卧位手术22例，俯卧位17例。中位年龄79岁对79岁，性别比为男：女=16：6/14：3。术前营养状况无显着差异。手术时间分别为 458 分钟和 501 分钟 (p = 0.126)。失血量为 318 mL 与 195 mL (p = 0.003)。复发性神经麻痹的发生率为 42.1% vs 29.4% (p = 0.262)。Clavien-Dindo ≥ III 并发症的患者人数为 40.9% 对 41.2% (p = 0.987)。3 年 OS 分别为 74.7% 和 77.3%，DFS 分别为 78.6% 和 67.7%。结论 ≥75岁的ESCC患者，俯卧位手术相对安全。失血量和复发性神经麻痹器往往较少。