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??Therapeutic effect of hybrid surgery for incarcerated or strangulated incisional hernia repair??An analysis of 11 cases LUO Wen??WANG Yong??DUAN Xin. Department of Hernia and Abdominal Surgery??the Central Hospital of Wuhan??Tongji Medical College Huazhong University of Science & Technology??Wuhan 430014??China
Corresponding author??WANG Yong??E-mail??rovine1984@sohu.Com
Abstract Objective To investigate the safety and effectiveness of a hybrid technique for incarcerated or strangulated incisional hernia repair. Methods The clinical and follow-up data of 11 cases of hybrid technique for incarcerated or strangulated incisional hernia repair performed from January 2011 to January 2015 in Department of Hernia and Abdominal Surgery??the Central Hospital of Wuhan??Tongji Medical College Huazhong University of Science & Technology were analyzed retrospectively. Results All cases were performed by hybrid technique successfully and without complications such as the injury of intestinal canal and cardiopulmonary failure after operations.We completed with a mean operation time of (151.9±65.2) min and found the diameter of the hernial ring of 3??8??4.5±1.2??cm. According to our statistics,10 cases of small bowel incarcerated with intestinal obstruction and 1 case of mesenteric incarcerated.4 cases of actually strangulation incision hernia with the small intestinal ischemic necrosis and were repaired in vitro.In addition,we found 4 cases of the occult hernial defects during the operation. The time of postoperative defecations was 3??9??4.1±2.2??d, and 4 cases of obvious symptoms of postoperative abdominal distension but recovered by treatment after 2 ~ 7d. All patients were followed up for 21(12??36) months. There was neither obvious seroma nor recurrence nor bulging. Conclusion The hybrid technique is safe and effective for incarcerated incisional hernia repair with less complication.     

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??Therapeutic effect of hybrid technique for difficult incisional hernia repair LIANG Qing-yu??XIE Jia-ming??WU Hao-rong??et al. Department of General Surgery??the 2nd Affiliated Hospital of Soochow University??Suzhou 215004??China
Corresponding author??WU Hao-rong??E-mail??wuhaorong@vip.sina.com
Abstract Objective To investigate the safety and effectiveness of a hybrid technique for difficult incisional hernia repair. Methods The clinical and follow-up data of 10 cases of hybrid technique for incisional hernia repair performed from April 2011 to November 2013 at the 2nd Affiliated Hospital of Soochow University were analyzed retrospectively. Results All cases were performed by hybrid technique successfully with a mean operation time of ??181.9±68.2??min (120—330 min) and a mean time of postoperative hospital stay of??8.7±1.6??days (6—10 days). Seven cases started laparoscopically and were converted to open for dif?cult adhesiolysis. The other three cases were started as open procedures. Intraoperative findings showed two cases of incarcerated intestine and three cases of occult hernia. Abdominal wall pain occurred in four cases and all of them relieved basically in four weeks. All patients were followed up for??19.3±12.0??months (4—35 months). There was neither obvious seroma nor recurrence nor bulging. Conclusion The hybrid technique is safe and effective for difficult incisional hernia repair with less complication.     

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??Long-term follow-up of lesser gastric curve and fundus seromyotomy for the treatment of duodenal ulcer and its complication: an analysis of 55 cases JIANG Xiao-chun*??XU Rui-yun. *Department of Surgery, the 113th Hospital of PLA, Ningbo 315040,China Corresponding author: JIANG Xiao-chun??E-mail: jiangxc1963@yahoo.cn Abstract Objective To research the long-term curative effects of lesser gastric curve and fundus seromyotomy (LGCFS) for the treatment of duodenal ulcer and its complications. Methods Fifty-five cases of duodenal ulcer performed LGCFS from 1983 to 1991 at the Third Affiliated Hospital of SUN Yat-sen University were followed up by means of letters, telephone and outpatient reexamine. The curative effects were classified by the Visick scale. Results Forty-seven cases were followed up.The Visick classification results were: (1) Twenty-five (78.1%), 2(6.3%), 3(9.4%) and 2(6.3%) cases being classified as Visick I,II,III,IV respectively among 32 cases without any complication.(2) Five (33.3%), 2(13.3%), 2(13.3%) and 6(40.0%) cases being classified as Visick I,II,III,IV respectively among 15 cases with complications. (3) Thirty (63.8%), 4 (8.5%), 5 (10.6% ) and 8 (17.0% ) cases were classified as Visick I,II,III,IV respectively among 47 cases. Conclusion LGCFS is simple and has few complications.The long term curative effect is good for duodenal ulcer without any complication.But it is bad for duodenal ulcer with complications,especially for duodenal ulcer with pyloric obstruction because of the high recurrent rate of pyloristenosis after LGCFS plus pylorodiosis.     

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目的评价腹腔镜下腹壁切口疝修补术的长、短期疗效。方法回顾性分析2006年3月至2011年7月苏州大学附属第二医院普外科41例行腹腔镜下腹壁切口疝修补术的临床资料。结果 41例切口疝均在腹腔镜下完成修补,手术时间45～150min,平均60min,术后住院时间3～16d,平均6d,术后随访2～65个月,平均25.6个月。发生血清肿4例,术后疼痛8例(术后3～6周缓解),补片感染1例,复发2例。结论腹腔镜腹壁切口疝修补术具有创伤小、恢复快、并发症少及复发率低等优点,是一种安全有效的手术方式。     

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??Hybrid technique in the treatment of the huge abdominal incisional hernia??An analysis of clinic therapeutic effect ZHU Yi-lin??CHEN Jie??SHEN Ying-mo??et al. Department of Hernia and Abdominal Wall Surgery??Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences??Beijing 100020??China
Corresponding author??CHEN Jie??E-mail??zhshfbwkzz@yahoo.com.cn
Abstract Objective To analyze the clinical value of the hybrid technique in the treatment of the huge abdominal incisional hernia. Methods The clinical data of 347 cases of huge abdominal incisional hernia admitted form January 2008 to May 2013 in Department of Hernia and Abdominal Wall Surgery??Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences were analyzed retrospectively. The operational course and the postoperative status among open (93 cases)??laparoscopic (152 cases) and the hybrid technique (102 cases) performed in huge abdominal incisional hernia were compared. Results The meantime of operation in the laparoscopic group???67.7±28.8??min?? was shortest and that in the hybrid group???103.1±30.6??min?? was longest. The length of incision in the hybrid groupp???8.2±4.0??cm?? was shorter than that in the open group???15.1±4.81??cm?? . The hospitalization stay in the open group and hybrid group was longer than that in the laparoscopic group. The follow-up ranged from 6 to 48 months. Twenty cases developed complication in the open group??30 in the laparoscopic group and 8 in the hybrid group. One case developed recurrence in the open group??1 in the laparoscopic group and none in the hybrid group. All the recurrent cases were cured by hybrid technique in 2 years after operation. Conclusion The hybrid technique is better than the other two in the treatment of the huge abdominal incisional hernia.     

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??Laparoscopic and hybrid laparoscopic robotic pancreaticoduodenectomy: a report of 80 cases HONG De-fei*??LIU Ya-hui??ZHANG Yu-hua??et al. *Department of Hepatobiliary and Pancreatic Surgery??minimally invasive surgery??Zhejiang Provincial People’s Hospital?? Hangzhou 310014??China
Corresponding author??HONG De-fei??E-mail??hongdefi@163.com
Abstract Objective To investigate the role of Laparoscopic and robotic assisted pancreaticoduodenectomy??LPD??in periampullary lesions. Methods The clinical data including perioperative and short-term outcomes of 80 cases of LPD performed in Zhejiang provincial people’s hospital (67) and Frist clinical hospital of Jilin university (13) between 2013.12 and 2016.01 were reviewed retrospectively. Results 80 patients attempted LPD while three ??3.8%?? required conversation to open procedure. Five patients ??6.3%?? underwent LPD combined with partial resection of portal vein or superior mesentery vein. The mean operation time was ??351.2±84.1??minutes??estimated blood loss was ??204.7±165.9?? ml and mean postoperative hospital stay was ??16.6±10.1?? days. Seven cases underwent binding pancreatico-gastric anastomosis while other cases were all underwent pancreatico-jejunostomy duct to mucosa anastomosis including 45 cases performed under laparoscopic system and 25 cases performed under Robotic system. 11 cases had pancreatic fistula according to ISGPF definition??including six cases of grade A??three cases of grade B and two cases of grade C (reoperation was required for postoperative intra-abdominal hemorrhage). Three patients suffered from postoperative intra-abdominal bleeding. Three patients had gastrointestinal bleeding. Five patients had delayed gastric empty and six cases had bile leakage after operation. Pathologic results showed pancreatic ductal adenocarcinomas in 32 patients??duodenal papillary adenocarcinoma in 16 patients??adenocarcinomas at ampulla of Vater or common bile duct in 23 cases??intraductal papillary mucinous neoplasms in four patients??neuroendocrine tumors in two patients and other disease in three patients. All patients underwent R0 resection. Conclusion Our results show that the LPD is technique safe and feasible at high volume minimal invasive and pancreatic centers. Da-Vinci robotic system has advantage in pancreatojejunal and portal vein reconstruction.     

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??The clinical application of a novel drainage tube on the pancreaticoduodenectomy XU Xue-Feng??LV Yang??LI jian-ang??et al. General Surgery Department??Zhongshan Hospital??Fudan University??Shanghai 200032??China
Corresponding author??JIN Da-Yong??E-mail??jin.dayong@zs-hospital.sh.cn
Abstract Objective To investigate the impact of using a novel drainage system in pancreaticoduodenectomy on the incidence rate of postoperative complications??especially the postoperative pancreatic fistula??. Methods The clinical data including the incidence rate and grade of postoperative pancreatic fistula and the occurrence rate of Biliary fistula??Delayed gastric emptying??bleeding and mortality within 30 days postoperative period of 93 patients who underwent pancreaticoduodenectomy using a novel drainage system from January 2009 to July 2011 were analyzed??retrospectively. Results The mean operation time was 199.2±46.4 minutes, with the amount of bleeding 190.8±193.2 ml , 8 patients were performed the intraoperative transfusion and volume of transfusion 2.0±0.2 units. None of all the patients appeared displacement and blockage of drainage tube. Inflammation and redness happened in 3 patients, of which 1 was found oozing. All the patients were followed up to 30 days after the operation. 57 patients were not observed with complications and were discharged successfully. Of the other 36 patients, the occurrence amount of pancreatic fistula is 22??with grade A??grade B and grade C amount 19, 3 and 0, respectively. 2 of the patients take place the Biliary fistula and 5 appeared delayed gastric emptying (DGE), 5 with pulmonary infection and 2 with wound infection. Conclusion The application of the novel two-point fixed??multisite running-through??double-lumen drainage tube in pancreaticoduodenectomy was safe??and could reduce the incidence of high grade pancreatic fistula.     

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??Near the second porta hepatic parenchyma lithotomy in the treatment of complicated bile duct stones??A analysis of 13 cases LI En-liang??WU Lin-quan??YIN Xiang-bao??et al. Department of Hepatobiliary Surgery??the Second Affiliated Hospital of Nanchang University, Nanchang330006??China
Corresponding author??WU Lin-quan, E-mail??Wulqnc@163.com
Abstract Objective To investigate the clinical significance of near the second porta hepatic parenchyma lithotomy in the treatment of complicated bile duct stones. Methods The clinical data of 13 cases of complex hepatolithiasis admitted from January 2009 to December 2013 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. Surgical methods were hepatic parenchyma incision lithotomy near the second hepatic portal, or combined partial hepatectomy. Thirteen cases include 6 males and 7 females. Stones are mainly located in section ??, ??, ?? section. Results One case died during hospitalization and the other cases were recovered and discharged. A total of 11 cases were followed up to now, during which residual calculi happened in 1 case, recurrent hepatolithiasis in 2 cases, and other cases showed no signs of recurrent calculus and cholangitis through using ultrasound or CT examination. Conclusion Hepatic parenchyma incision lithotomy near the second hepatic portal used to treat those cases whose stones mainly located in??, ?? and ?? segments accompanied by partial liver compensatory hypertrophy around the lesions and those cases who cannot tolerate multiple hepatic segment resection has a better effect.     

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目的对第一肝门阻断和选择性肝血流阻断(SHVE)在肝切除术的疗效进行综合比较及Meta分析。方法对1996年5月至2011年7月通过Medline、Elsevier、中国期刊全文数据库、万方数据检索、Pubmed发表的有关肝切除术中采用第一肝门阻断和SHVE进行肝血流阻断的相关随机对照研究(RCT)文献,采用Cochrance协作网提供的ReMan5.1软件用固定效应模型进行Meta分析。结果按照入选标准,有9项临床试验纳入。Meta结果显示:SHVE组术中出血量较第一肝门阻断组少131.29mL(P<0.001);手术时间SHVE组较第一肝门阻断组延长12.66min;住院时间SHVE组较第一肝门阻断组少2.68d(P<0.001);SHVE组术后肝功能衰竭发生率以及其他并发症(包括大量腹水、胸腔积液、肺部感染等)发生率较第一肝门阻断组明显降低(P<0.05);胆漏发生率两组差异无统计学意义(P>0.05)。结论肝脏手术中采用选择性肝血流阻断安全可靠,相比传统第一肝门阻断减少了术中出血、缩短术后住院时间,降低了肝功能衰竭等并发症发生率。     

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??Reasonable application and efficacy of laparoscopic radical gastrectomy for gastric cancer HUANG Chang-ming, LIN Jian-xian. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
Corresponding author: HUANG Chang-ming, E-mail: hcmlr2002@163.com
Abstract Laparoscopic radical gastrectomy has a nearly 20 years’ history. Nowadays, application of laparoscopic radical gastrectomy for early gastric cancer has been made in the consensus at home and abroad. The operation has already achieved good clinical efficacy in advanced gastric cancer. But it still needs the results of multi-center prospective randomized controlled study to evaluate the advantages and disadvantages of laparoscopic surgery. Only surgeon chose the right surgical cases and followed the principles of radical cancer surgery strictly, laparoscopic radical gastrectomy can be done with not only the advantages of minimally invasive, but also the similar long-term effect compared with the open surgery.     

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??Evaluation of porcine small intestinal submucosa acellular matrix patch for incisional hernia repair DAI Wei-gang, YUAN Yu-jie, TAN Jin-fu,et al. Department of Gastrointestinal, Hernia and Abdominal Wall Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
Corresponding author: TAN Min, E-mail: tantommy@163.com
Abstract Objective To evaluate the safety and efficacy of porcine small intestinal submucosa acellular matrix patch for incisional hernia repair. Methods From March 1, 2012 to March 31, 2017, the clinical data of 19 cases of incisional hernia underwent herniorrhaphy by porcine small intestinal submucosa acellular matrix patch in the First Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively. Results There were 5 cases (26.3%) of male patients and 14 cases (73.7%) of female patients in the total 19 cases. The ratio of male and female was 1??2.8. The median age was 67??from 38 to 81?? years old. The average BMI was 27.7± 2.2. The median operative time was 170??from 65 to 390??minutes. The median length and width of hernia ring measured in operation were 8 (from 3 to 20) centimeters and 7(from 3 to 15) centimeters respectively. There were 14 cases (73.7%) of clean surgery, 4 cases (21.0%) of potential contaminative surgery and 1 case (5.3%) of contaminative surgery. The numerical rating scale (NRS) of pain on the 24 hours??third and seventh day after the operation were 5.1±0.8, 4.2±0.7 and 3.6±0.8 respectively. The first exhaust time after operation was 2.2±0.8 days. There was no death during perioperative time. The median hospitalization time was 18 (from 4 to 50) days. The incidence of postoperative complications was 52.6% (10/19). The complications included: fever (26.3%,5/19),incisional complications (47.4%, 9/19), abdominal infection (21.1%,4/19),intestinal obstruction(21.1%,4/19),pneumonia (10.5%,2/19), acute myocardial infarction(5.3%,1/19).Seven patients were reviewed for CT afteroperation, of which 5 cases had different degrees of effusion under the patch and 2 were infected. According to the Clavien-Dindo classification, from zero to fourth level were 47.4% (9/19), 10.5% (2/19), 31.6% (6/19), 5.3% (1/19), and 5.3% (1/19) respectively. The follow-up rate was 94.7% (18/19) and the median time were 26.6(from 8.0 to 60.0) months. Two patients (11.1%, 2/18) died after the operation due to other diseases. Chronic abdominal pain or discomfort accounted for 26.3% (5/18). The recurrence ratio of incisional hernia was 26.3% (5/18) and its median time was 12 (from 1 to 24) months. Conclusion Porcine small intestinal submucosa acellular matrix patch can be used safely and effectively in the repair of incisional ventral hernia, especially in the infected or potentially contaminated surgery. But it has high complication rate and hernia recurrence rate. Obviously, long-term follow-up is still required.     

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??Laparoscopic anatomical hepatectomy of hepatic vein approach??A therapeutic analysis of 97 cases CHENG Wei, ZUO Zhi, LIU Yi, et al. Department of Hepatobiliary Minimally Invasive Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
Corresponding author??YIN Xin-min, E-mail:13319587618@163.com
Abstract Objective To investigate the clinical outcomes on laparoscopic anatomical hepatectomy through hepatic vein approach. Methods The data of 97 cases of laparoscopic anatomical hepatectomy through hepatic vein approach between January 2013 and December 2016 in Hunan Provincial People's Hospital were reviewed retrospectively. Results Seventy cases underwent vascular inflow control by Pringle’s maneuver ,in the mode of “15+5”, 6 times at most. Also, 60 and 24 cases subjected to the Glisson intra-and extra-pedicles vascular inflow occlusion respectively. The operative time was (305.3±156.1)min, the blood loss was (133.3±170.4)mL. Three cases conversed to open surgery. Acfter operation, 4 cases showed pleural effusion, 1 case showed bile leaks and 1 case showed wound infection, which resolved on hospital non-operative treatment. No case performed reoperation and no death occurred. The hospital stay was (16.1±5.5) days. Conclusion Laparoscopic anatomical hepatectomy through hepatic vein approach can be implemented efficiently and effectively with the insurance of instrument, method and surgical manipulation.     

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??Diagnostic value of frozen section for thyroid carcinoma variants PING Bo. Department of Pathology??Fudan University Shanghai Cancer Center??Department of Oncology??Shanghai Medical College??Fudan University??Shanghai 200032??China
Abstract As relatively uncommon or even rare diseases, variants of thyroid carcinoma have different pathological features from those of the conventional types. Besides, a couple of the variants are more invasive and show comparatively worse prognosis, thus becoming high-risk histology types. Identifying the variants pre- or intraoperatively would therefore benefit surgical planing. Although the accuracy of type-specific diagnosis is more often guaranteed by post-operative paraffin section and /or immunohistochemistry rather than by frozen section (FS) , the latter remains an important role in improving the diagnosis of those thyroid carcinoma variants with indeterminate or misleading preoperative judgement.     

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直肠癌手术切口入路是一个探讨时间较长的话题,选择不同的切口,对术中和术后都有一定的影响。本文对直肠癌根治术采用横切口这一问题进行探讨。1腹部纵切口与横切口腹部手术切口可以分为纵切口、横切口、斜切口及其他特殊切口。选择切口首先要方便进行手术,达到预期手术目的;要便于切开和缝合,减少手术时间;要利于腹壁功能     

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??Laparoscopic herniorraphy for abdominal multiple incisional hernia XU Da-hua, LIU Jia-feng, LIU Dong-bin, et al. Department of General Surgery, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China Corresponding author: XU Da-hua, E-mail: dahuax @ yahoo.com.cn Abstract Objective To evaluate the surgical skill and the efficacy of laparoscopic herniorraphy for abdominal multiple incisional hernia. Methods A complicated case of four position abdominal incisional hernia from three times of surgery admitted in February 2008 at Beijing Xuan Wu Hospital of Capital Medical University was treated by laparoscopic herniorraphy with laparoscopic hernia clip and a large composix mesh. Results The length of hernia defects was 12cm, 9cm, 6cm and 3cm. A laparoscopic herniorraphy was succeed in the case of abdominal multiple incisional hernia without complication of intestinal injury. The case was followed-up for 6 months and no abdominal incisional hernia recurrent. Conclusion Laparoscopic herniorraphy is safe and effective for abdominal multiple incisional hernia. Laparoscopic herniorraphy is simple for the exploration of abdominal multiple incisional hernia defects, but open herniorraphy is more difficult. Laparoscopic herniorraphy is not only a minimally invasive surgery, but also a superior surgical skill for abdominal multiple incisional hernia.     

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??Abdominoinguinal incision in the resection of large soft tissue tumor at the area of iliac fossa??A report of 15 patients QIU Hui??Wu Jian-hui??LI Cheng-peng??et al. Sarcoma Center??Peking University Cancer Hospital & Institute??Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education)??Beijing 100142??China
Corresponding author??HAO Chun-yi??E-mail??haochunyi@vip.sina.com
Abstract Objective To explore the safety and feasibility of abdominoinguinal incision in large tumors at the area of the iliac fossa. Methods A total of 15 cases of large tumor at the area of the iliac fossa were performed operation through the abdominoinguinal incision from August 2015 to February 2018 in Sarcoma Center of Peking University Cancer Hospital.The clinical data were analyzed retrospectively. Results Complete resection were successfully performed in all patients??13 R0 resection????combined with 13 colectomy??9 nephrectomy??4 total/partial cystectomy??4 adnexectomy/orchiectomy and 10 partial resection and reconstruction of external iliac vessels. The operation time and blood loss was 360 to 720 min and 500 to 8000 mL respectively. One wound infection??6.7%??was observed??and no patient died in hospital. Conclusion The abdominoinguinal incision has a good exposure for the removal of large tumors at the area of iliac fossa.The tumors could be resected integratedly and safely.     

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溃疡病的发病率在高峰时期曾高达人群的 1 0 % ,但近30年来不断下降 ,尤以十二指肠溃疡 (ＤＵ)最为明显 ,致使与胃溃疡 (ＧＵ)之比由原来 1 0∶1降至 <2∶1。有人将发病率陡降归功于Ｈ2 受体拮抗剂高疗效的结果 ,但流行病学调查表明早在此类药物问世的十几年前 ,ＤＵ的发病率已开始下降。近年应用的Ｈ2 受体拮抗剂及质子泵抑制剂治疗ＤＵ的疗效甚佳 ,但停药后 1年复发率却高达 5 0 %～ 80 % ,需要再治或长期半量维持。而且 5 %～ 1 0 %的病例无论何种药物均不能使溃疡愈合 ,成为难治性溃疡 (ｒｅｆｒａｃｔｏｒｙｕｌｃｅｒ)。因此目前ＤＵ…     

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??Outcomes evaluation of endoscopic submucosal dissection for relative indication group of early esophageal squamous cell carcinoma in aged patients: An analysis of 69 cases LI Bing??QI Zhi-peng??ZHOU Ping-hong??et al. Endoscopy Center and Endoscopy Research Institute??Zhongshan Hospital??Fudan University??Shanghai 200032??China
Corresponding author??ZHONG Yun-shi??E-mail??zhong.yunshi@zs-hospital.sh.cn
Abstract Objective To evaluate the safety??efficacy and long-term outcomes of endoscopic submucosal dissection (ESD) for relative indication group of early esophageal squamous cell carcinoma in aged patients. Methods The clinical data of early esophageal squamous cell carcinoma treated by ESD from January 2008 to December 2013 in the Endoscopy Center of Zhongshan Hospital, Fudan University were analyzed retrospectively. A total of 69 cases of elderly patients were with the relative indications from the part of endoscopic treatment of Guidelines for Diagnosis and Treatment of Carcinoma of the Esophagus April 2012 edited by the Japan Esophageal Society and no additional treatment were picked out. The incidence of complications and long-term outcomes were observed and analyzed. Results 62 (89.9%) cases were infiltrated to muscularis muscular (M3)??7 (10.1%) cases were infiltrated into submucosal within 200 μm (SM1); 6 (8.7%) cases were lymphatic infiltration. There were 1 (1.4%) case with postoperative bleeding who underwent endoscopic hemostatic procedures after the ESD??2 (2.9%) cases with perforation who underwent the endoscopic suturing closure and 22 (31.8%) cases with esophageal stricture after operation. The recurrence rate was 11.6% (8/69) and the median recurrence time was 24 months. Liver and lymph node metastasis were existed in 1 case. As a result??the 5-year disease-free survival rate was 86.2%. The 5-year overall survival rate was 90.0% in the case of 4 patients (5.8%) died??and the median survival time was 56 months. Conclusion ESD could achieve comparatively ideal long-term outcomes in the treatment of early esophageal squamous cell carcinoma of aged patients without additional treatment, which has high safety and effectiveness.