早期食管鳞状细胞癌及癌前病变内镜黏膜下剥离术后切缘阳性的危险因素分析

[目的]研究早期食管鳞状细胞癌(esophageal squamous cell carcinoma, ESCC)及癌前病变行内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)后切缘阳性的相关危险因素及其预后情况。[方法]对因早期ESCC和(或)癌前病变行ESD后患者的临床病理资料行回顾性研究。根据术后病理组织切缘是否阳性,分为切缘阳性组和切缘阴性组,收集2组患者临床、内镜、病理学结果,分析术后切缘阳性发生的危险因素和预后情况。[结果]共纳入患者88例,切除病灶99处,切缘阴性85处,切缘阳性14处,切缘阳性率为14.14%(14/99),局部复发率为1.01%(1/99)。单因素分析提示,2组手术时间、术后并发症、标本长度、环周面积、钳检组织学异同、病理类型比较差异有统计学意义。切缘阳性组内镜随访,追加手术3例,术后病检均未发现淋巴结转移;1例在随访9个月后发现复发并有新发病灶,再次行ESD。[结论]标本长度和病理类型是ESCC及癌前病变ESD术后切缘阳性的独立危险因素,临床医生需严格把控适应证,加强ESD术中、术后的质量管理。     

内镜黏膜下剥离术治疗下咽早期癌及癌前病变的临床价值(含视频)

目的探讨内镜黏膜下剥离术（endoscopic submucosal dissection,ESD）治疗下咽早期癌及癌前病变的有效性及安全性。方法回顾性分析2015年12月—2019年5月在四川省肿瘤医院接受ESD的23例下咽早期癌及癌前病变患者的临床资料。结果23例患者共30处病灶纳入研究,患者均为男性,平均年龄60.3岁(47~72岁)。23例患者中,13例伴同时性食管癌,3例伴异时性食管癌,7例伴同时性食管高级别上皮内瘤变。患者均成功完成ESD,平均手术时间74 min,整块切除率100%。术后病理提示21处为高级别上皮内瘤变、8处为黏膜内癌、1处为黏膜下深浸润癌。水平切缘阳性2例,垂直切缘阳性1例,治愈性切除率90%。术中及术后无严重出血、穿孔、呼吸困难等并发症。结论ESD治疗下咽早期癌及癌前病变安全可行,值得在临床中推广应用。     

内镜黏膜下剥离术治疗早期食管癌及癌前病变44例

目的:探讨内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗早期食管癌及癌前病变的临床疗效及安全性评价.方法:收集2007-07/2010-06经胃镜检查、病理证实并行ESD治疗的44例早期食管癌或癌前病变患者,对其临床病理特征进行总结,并对疗效、并发症及生存率进行评估.结果:44例患者均成功地接受ESD,所有剥离标本全部得到病理确诊,基底和切缘未见病变累及.共出现出血2例,穿孔2例,食管狭窄3例.术后仅1例患者出现复发,行第2次ESD.结论:ESD治疗早期食管癌及癌前病变安全、有效,值得推广.     

内镜黏膜剥离术在早期食管癌及癌前病变中的疗效观察

[目的]观察内镜黏膜下剥离术(ESD)在早期食管癌及癌前病变中疗效。[方法]对152例共165处早期食管癌及癌前病变病灶行ESD治疗的临床资料进行回顾性分析。[结果]152例患者共165处病灶,病灶长度1.5~9.0cm,平均4.2cm,ESD平均手术时间75 min。术后穿孔2例(1.3%),出血1例(0.6%),食管狭窄9例(5.9%)。病理结果示低级别上皮内瘤变35例,水平切缘阳性1例,完全切除率97.1%(34/35);高级别上皮内瘤变63例,水平切缘阳性3例,完全切除率95.2%(60/63);食管早癌54例,水平切缘阳性3例,完全切除率94.4%(51/54);食管浅表癌13例,其中垂直切缘阳性3例,水平切缘阳性3例,完全切除率53.8%(7/13)。112例完成了术后1个月的胃镜复查,创面愈合率为100%;89例完成了术后6个月的胃镜复查,创面愈合率为100%,发现2例局部复发(2例均为高级别上皮内瘤变);68例完成了术后12个月的胃镜复查,创面愈合率为100%,发现3例复发(2例早癌,1例食管浅表癌)。[结论]ESD是治疗早期食管癌及癌前病变的有效安全的方法。     

隧道法内镜黏膜下剥离术在食管早期癌及癌前病变中应用的研究

目的 探讨隧道法黏膜下剥离术治疗食管早期癌或癌前病变的应用价值及操作技术要领.方法 2010年1月～ 2011年10月在我科内镜中心通过胃镜活检及超声胃镜诊断食管早期癌及上皮内瘤变、深度未超过黏膜下层者7例,应用隧道法ESD(病变黏膜下层建立隧道)治疗.结果 7例病变均一次性完整切除,病变直径2.0～4.0cm,手术时间为37 ～ 110 min,经病理证实基底部及切缘未见病变累及,2例出现术中出血量较多,均内镜下成功止血,无迟发性出血者,所有病例均无穿孔者,术后3个月及半年复查创面愈合良好,均无复发.结论 隧道法ESD是治疗早期食管癌及癌前病变的良好方法,隧道法ESD与传统ESD相比,缩短了内镜手术时间,简化了操作步骤,使得内镜手术更安全更快捷.     

内镜黏膜下剥离术诊治高度可疑结直肠癌或癌前病变及共聚焦激光显微内镜在随访中的价值

目的探讨内镜黏膜下剥离术(Endoscopic submucosal dissection,ESD)治疗和诊断高度可疑或早期结直肠癌和癌前病变的有效性和安全性,比较整块活检病理与内镜活检病理对早期癌诊断意义及共聚焦激光显微内镜在随访中的价值。方法对于内镜下高度可疑早期结直肠癌或早期结直肠癌及癌前病变的19例患者行ESD治疗,术后评价ESD治疗相关的一次性整块切除率、组织学治愈性切除率、手术并发症;比较术后整块病理与术前内镜活检诊断符合率;在术后随访时用共聚焦激光显微内镜检查(1、3个月)以指导活检并观察局部复发情况。结果 19处病灶一次性整块切除率为94.7%(18/19),组织学治愈性切除率为84.2%(16/19);病变平均大小(2.3±0.5)cm,平均手术时间(70±19.4)min;术后腹痛2例,延迟性出血1例,内镜下钛夹止血成功,其余病例未发生急性或延迟性出血以及穿孔;术后病理:黏膜内癌7例,癌前病变10例,黏膜下癌2例,其中2例黏膜下癌均进一步补充开腹手术,术后切除病变肠段未发现癌组织残留和周边淋巴结转移;所有病例术后平均随访(24.6±8.0)个月,局部未见残留、复发及异时病灶发生;其中7例黏膜内癌ESD术后1、3个月采用共聚焦激光显微内镜检查以指导活检进行随访未见癌组织残留及复发。19处病灶ESD术后大块组织病理诊断符合率为100%,而术前活检病理诊断符合率仅为57.9%,有统计学意义(P0.01)。结论 ESD具有较高一次性整块切除率和组织学治愈性切除率,是一种治疗和诊断高度可疑或早期结直肠癌病变或癌前病变的安全有效的方法。共聚焦激光显微内镜可能对早期结直肠癌的术后随访具有一定的价值。     

探讨黏膜下剥离术与黏膜切除术在上消化道早癌及癌前病变中的应用

目的分析黏膜下剥离术(ESD)与黏膜切除术(EMR)在上消化道早癌及癌前病变中的应用价值。方法将自贡市第四人民医院2013年1月至2015年12月收治并经病理确诊的71例上消化道早癌或癌前病变患者按手术方式分ESD组(32例)、EMR组(39例);比较两组一般手术情况,随访统计复发情况,绘制Kaplan-Meier生存曲线比较两组复发情况。结果两组术中出血量、并发症发生率、病灶组织学切除情况、术后住院时间比较差异无统计学意义(P 0. 05),但ESD组手术时间较EMR组长,术中切除黏膜直径显著大于EMR组;以复发为结局绘制Kaplan-Meier生存曲线,两组3年累积无复发生存率分别90. 60%、84. 30%,经Log-rank分析差异无统计学意义(χ~2=0. 747,P=0. 387)。结论 ESD、EMR在上消化道早癌及癌前病变中均有良好的临床应用价值,应引起临床重视。     

内镜黏膜下剥离术治疗上消化道神经内分泌肿瘤的临床价值

目的 探讨内镜黏膜下剥离术(ESD)治疗上消化道神经内分泌肿瘤的安全性及其疗效.方法 采用ESD方法对19例上消化道神经内分泌肿瘤进行治疗,术后标本送病理检查,记录不良反应发生情况及疗效,随访肿瘤复发及转移情况.结果 肿瘤直径0.4 ～1.5 cm,平均0.9 cm,均一次性完整剥离切除,ESD手术时间(自黏膜下注射至完整剥离病变)15～ 50 min,平均20 min,无严重出血及穿孔发生.术后18例病理诊断为神经内分泌瘤,其中G1级16例、G2级2例,基底和切缘均未见病变累及;另1例病理显示有浸润性生长倾向,诊断神经内分泌癌(G3级),行外科扩大切除,术后病理未见肿瘤组织残留,无淋巴结转移.平均随访28个月,无一例出现肿瘤复发和转移.结论 ESD治疗上消化道神经内分泌肿瘤具有较好的安全性和疗效,值得在临床上推广应用.     

早期胃癌及癌前病变内镜黏膜下剥离术后切缘阳性的危险因素与随访分析

目的探究早期胃癌及癌前病变内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)后切缘阳性的危险因素, 并随访复发情况。方法回顾性收集2015年1月—2020年12月在福建省立医院经ESD治疗的489例早期胃癌及癌前病变患者的内镜、临床及病理资料, 根据切缘情况分为切缘阴性组(371例)、切缘低级别上皮内瘤变(low grade intraepithelial neoplasia, LGIN)组(79例)及切缘高级别上皮内瘤变(high grade intraepithelial neoplasia, HGIN)或癌组(39例)。采用logistic回归分析切缘阳性的危险因素, Kaplan-Meier法和log-rank检验对比不同切缘组复发风险, 采用Cox比例风险回归模型探讨阳性者复发的相关因素。结果 489例患者中, 切缘阳性率24.1%(118/489), 其中HGIN或癌占33.1%(39/118)。病灶面积>10 cm2(OR=1.58, 95%CI:1.13～2.08, P=0.033)、存在溃疡(OR=2.92, 95%C...     

内镜黏膜下剥离术治疗食管早期癌及癌前病变

目的 探讨内镜黏膜下剥离术(ESD)治疗食管早期癌及癌前病变的应用价值.方法 对胃镜发现的食管早癌和上皮内瘤变、深度未超越黏膜卜层者15例进行ESD治疗:(1)黏膜下注射生理盐水抬高病变;(2)预切开病变周围黏膜;(3)沿病变下方黏膜下层完整剥离病变.结果 15例食管早癌和上皮内瘤变病变,最大卣径2.5～4.5 cm(平均3.2 cm).14例病变成功完成ESD治疗,ESD成功率93.3%(14/15).所有剥离病变全部得到病理确诊,基底和切缘未见病变累及.ESD手术时间(白黏膜下注射至完整剥离病变)45～150 min,(平均75 min).术中出血量平均30 ml,均经电凝、氙离子凝固术和止血夹成功止血,未出现需再次内镜下治疗的出血;ESD穿孔发生率0(0/15).术后随访14例,随访期6～18个月(平均11.5个月),创而完全愈合,无一例病变残留和复发.结论 ESD是治疗食管早癌和癌前病变的新方法,不仅能完整切除较大的病变,还能提供完整的病理学诊断资料.     

Need for Guidelines in Gastroenterology for the General Practitioner

General practitioners base their clinical strategy on evidence-based medicine and experience. When prospective randomized controlled studies have not provided an answer to a specific clinical question, or when common practice in a certain area is not well established, guidelines formulated by specialists with in-depth knowledge of the field are needed. Studies have shown that gastroenterology guidelines have improved the approach to Helicobacter pylori infection and the management of gastroesophageal reflux disease. Failure to use these guidelines by general practitioners can lead to diagnostic inconsistencies and faulty patient care. This is particularly important in Israel, where the heterogeneous patient and physician populations are characterized by differences in the interpretation of symptoms, disease prevalence, and education.     

A Protocol for Screening for Diabetic Retinopathy in Europe

Diabetic eye complications, and particularly diabetic retinopathy, are the major cause of blindness in the working age groups of industrialized countries. Laser photocoagulation has been proven to reduce blindness due to retinopathy by at least 60 % but even more patients would benefit if treatment were delivered at an early enough stage. High-risk retinopathy, though, may not cause visual symptoms, and when the latter occur it is often too late to reverse them. Hence, a screening programme for diabetic retinopathy should aim at detecting patients at risk when they can still be effectively treated. This can be achieved by regularly checking the patients' eyes. The screening programme's target, as defined by the joint World Health Organization/International Diabetes Federation Saint Vincent Declaration Working Group, is to reduce diabetes-related blindness by one-third or more in the next 5 years. The number of individuals to be screened is high, 30000 per million total population per year, but available data indicate that this is feasible and that the initial investments in professional and material resources are more than justified by the reduction of preventable blindness and of the financial burdens that go with it. Indeed, prevention of the major cause of blindness in the working age group should rate the same priority as other widely deployed programmes, such as those to screen for cancer, neonatal hypothyroidism, and phenylketonuria. The concerted action of government health departments, patients' and professional associations will be vital for the successful implementation of this programme. The texts of this document (a protocol for the screening of diabetic retinopathy and cataract), Appendix 1 (information leaflet for the patients), and Appendix 2 (data collection card) were approved by 57 specialists, representing 30 diabetic and ophthalmic societies from 21 European countries, and endorsed for translation into all European languages and distribution at the appropriate levels.     

Recommendations for in-clinic PoCT for diabetes management in India

A panel of expert diabetologist clinicians developed consensus standards to address the quality gaps inclinic point of care testing (PoCT) especially pertaining to diabetes care and management in India. The following summarized principles were established- 1. PoCT definition, 2. Advantages and critical aspects of PoCT including guideline recommendations and accreditations, analytical factors (pre &post analytical included) and consensus reached for an ideal PoC analyzer and 3. Key recommendations on in-clinic PoCT implementation by the panel. The experts suggested next steps that included key comparative (PoCT vs NGSP accredited lab) and patient benefit studies on PoCT.     

Thromboembolic disease in surgery for malignancy-rationale for prolonged thromboprophylaxis

Patients undergoing surgery for malignancy are at increased risk of initial and recurrent venous thromboembolism (VTE). Several factors have been found to increase the risk of deep vein thrombosis (DVT) in cancer patients both during the first days after the operation and after discharge from hospital. Although, in general, thromboprophylaxis is provided to cancer patients after surgery, the length of time these patients require prophylaxis has not yet been established. Autopsy series, clinical series, and clinical trials indicate that up to about 40% of VTE occurs post discharge. General surgical patients undergoing major abdominal surgery require VTE prophylaxis, and prolonged thromboprophylaxis should be considered in the post-discharge period in high-risk patients, particularly those with cancer. Evidence from studies in general and orthopedic surgery show that prolonged prophylaxis reduces the number of thromboembolic events after discharge from hospital. Prophylaxis should be simple, safe, and effective and should be administered easily to allow continuation of therapy after discharge. Low-molecular-weight heparins are potentially the most suitable agents for long-term thromboprophylaxis in cancer patients.     

Algorithm for questionning women in screening for stenocardia of effort in epidemiological research

A new algorithm is proposed for the questioning of female subjects in screenings for angina of effort, that differs in certain respects from the anginal diagnosis algorithm using standard cardiologic questionnaire currently accepted in epidemiologic studies. The advantages of the modified questionnaire make it more suitable for the screening of female populations.     

Requirement for an Otopetrin-like protein for acid taste in Drosophila

Receptors for bitter, sugar, and other tastes have been identified in the fruit fly Drosophila melanogaster, while a broadly tuned receptor for the taste of acid has been elusive. Previous work showed that such a receptor was unlikely to be encoded by a gene within one of the two major families of taste receptors in Drosophila, the “gustatory receptors” and “ionotropic receptors.” Here, to identify the acid taste receptor, we tested the contributions of genes encoding proteins distantly related to the mammalian Otopertrin1 (OTOP1) proton channel that functions as a sour receptor in mice. RNA interference (RNAi) knockdown or mutation by CRISPR/Cas9 of one of the genes, Otopetrin-Like A (OtopLA), but not of the others (OtopLB or OtopLC) severely impaired the behavioral rejection to a sweet solution laced with high levels of HCl or carboxylic acids and greatly reduced acid-induced action potentials measured from taste hairs. An isoform of OtopLA that we isolated from the proboscis was sufficient to restore behavioral sensitivity and acid-induced action potential firing in OtopLA mutant flies. At lower concentrations, HCl was attractive to the flies, and this attraction was abolished in the OtopLA mutant. Cell type–specific rescue experiments showed that OtopLA functions in distinct subsets of gustatory receptor neurons for repulsion and attraction to high and low levels of protons, respectively. This work highlights a functional conservation of a sensory receptor in flies and mammals and shows that the same receptor can function in both appetitive and repulsive behaviors.

Humans possess the ability to distinguish among five basic tastes: sweet, bitter, salt, sour, and umami. Interestingly, there is considerable variety in the ability of other mammals to detect these qualities. For example, cats are missing sweet taste (1) and the bottlenose dolphin only detects salt in food (2). Yet the fruit fly, Drosophila melanogaster, responds to a similar repertoire of tastes as humans. This is all the more remarkable given the very distant evolutionary relatedness and the enormous differences in the anatomy of the fly and mammalian taste organs and points to a conserved function of these taste qualities in assessing food quality.Many of the receptors involved in Drosophila taste have been defined (3, 4). Those that contribute to sweet and bitter tastes have been characterized extensively and are members of the “gustatory receptor” (GR) family (3, 4). GRs are unrelated to the G protein–coupled receptors that function in mammalian sweet and bitter taste (3). Therefore, the abilities of insects and humans to respond to similar repertoires of chemicals such as sweet and bitter tastants have emerged independently.In mice, the taste of acids depends on a proton-selective channel, Otopetrin1 (OTOP1), which is expressed in type III taste receptor cells (5–7). OTOP1 was first identified based on its essential role in the vestibular systems of the mouse and zebrafish (8–11) and was found to encode a family of proton-selective ion channels functionally conserved from worms to humans (5, 9, 12). In sea urchins, an Otop channel functions in calcifying primary mesenchymal cells by promoting the removal of protons generated during the production of CaCO₃ (13). Otop family members are structurally unrelated to other ion channels and are composed of 12 transmembrane segments (12, 14, 15), which assemble as a dimer with no obvious permeation pathway (14, 15). Flies, mice, and human genomes each contain three otop genes, although the fly genes are not direct homologs of the vertebrate genes (9).In Drosophila, low or moderate levels of some organic acids are attractive and promote feeding, while the same acids at higher concentrations repress food consumption (16, 17). This rejection contributes to survival as it discourages the animals from eating very acidic foods in the environment that can decrease lifespan. Two members of the large family of “ionotropic receptors” (IRs; IR25a and IR76b) function in GR neurons (GRNs) in the legs for sensing carboxylic acids and HCl (18). Mutation of either of these IRs disrupts the preference to lay eggs on acid-containing substrates (18). Flies prefer consuming lactic acid over water, and this preference is mildly reduced in Ir25a mutants (19).The receptors required for the gustatory rejection of noxious levels of acids have been largely enigmatic. An exception is IR7a, which is needed to suppress feeding on foods laced with acetic acid (17). IR7a is very narrowly tuned, as it does not impair the rejection of foods with HCl or any other carboxylic acid tested. This receptor acts in a subset of GRNs called B GRNs that are also activated by bitter chemicals and certain other aversive compounds (4, 17).Here, we identified a member of the family of Otop channels that in Drosophila is required for the detection of protons in food. Wild-type flies are strongly repelled by high levels of HCl and mildly attracted to a low level of HCl. We found that these responses depend on the Otopetrin-Like protein (OtopLA), which has a common evolutionarily origin with mammalian OTOP channels. By performing cell type–specific rescue experiments, we found that the strong repulsion and mild attraction to different levels of acids depends on expression of OtopLA in distinct subsets of GRNs.     

Indications for cholecystectomy in diabetics

Summary On the basis of experiences gained in operations for biliary tract concretions carried out in 50 diabetic patients, the indications for cholecystectomy are established. The AA. consider timely cholecystectomy, even in cases of an asymptomatic course of cholelithiasis, because diabetic diseases of the biliary tract are more serious and more prone to complications. They observed improvement of the carbohydrate metabolism after the operations in cases where diabetes had been of a short duration (less than one year). The operation death rate did not differ from that of non-diabetics in the age group up to 60; in older patients the more unfavourable death rate was caused by vascular complications and by increased predisposition to infection.

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Zusammenfassung Die Indikationen fuer die Cholezystektomie wurden bei 50 Diabetikern auf der Grundlage der eingeholten Erfahrungen bei Gallensteinentfernungen der Gallenwege gestellt. Die AA. halten die Cholezystektomie auch im Falle eines asymptomatischen Verlaufs der Cholelithiasis fuer angebracht, da die Gallenwegserkrankungen bei den Diabetikern sehr schwerer Natur sind und mehr zu Komplikationen neigen. Sie beobachteten eine Besserung des Kohlenhydratstoffwechsels nach dem Eingriff bei denjenigen Faellen, wo der Diabetes seit kurzer Zeit im Gange war (seit weniger als einem Jahr). Die Operationsmortalitaet unterschied sich in der Altersgruppe bis zu 60 Jahren nicht von der der nicht Diabetiker; bei den aelteren Patienten hingegen war die hoehere Mortalitaet den Gefässkomplikationen und der erhoehten Praedisposition gegenueber Infektionen zuzuschreiben.

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Resumen Las indicaciones de la colecistectomía han sido establecidas en base a las experiencias recogidas en intervenciones de remoción de cálculos de las vías biliares en 50 diabéticos. Los AA. consideran oportuna la colecistectomía también en los casos de curso asintomático de la colelitiasis, dado que en los diabéticos las afecciones de las vías biliares son de carácter muy grave y están más propensas a las complicaciones. Los AA. han observado una mejoría en el metabolismo de los glúcidos después de la intervención, en los casos en los cuales el diabetes había tenido una duración breve (inferior a un año). La mortalidad operatoria no difería de la mortalidad en los no diabéticos en el grupo de edad hasta los 60 años, mientras que en los pacientes de edad más avanzada la más alta mortalidad era atribuible a las complicaciones vasculares y a la aumentada predisposición a las infecciones.

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Resume On a déterminé les cas où la cholécystectomie est indiquée sur la base de l'expérience acquise au cours de l'exérèse de calculs des voies biliaires chez 50 diabétiques. Les AA. ont estimé que le recours à la cholécystectomie était opportun même en cas de décours asymptomatique de la cholélithiase, ceci parce que les affections des voies biliaires chez les diabétiques revêtent une forme très grave et ont plus tendance à entraîner des complications. Après l'intervention les AA. ont observé une amélioration du métabolisme glucidique pour les cas dans lesquels le diabète était très récent (moins d'un an). La mortalité opératoire a été semblable à celle des non diabétiques pour le groupe d'âge allant jusqu'à 60 ans, tandis que chez les patients plus âgés la plus forte mortalité a été attribuée aux complications vasculaires et à une prédisposition accrue aux infections.

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Riassunto Le indicazioni per la colecistectomia sono state stabilite sulla base delle esperienze raccolte in interventi di rimozione di calcoli delle vie biliari in 50 diabetici. Gli AA. considerano opportuna la colecistectomia anche in caso di un decorso asintomatico della colelitiasi, poichè nei diabetici le affezioni delle vie biliari sono di natura molto grave e più inclini alle complicazioni. Essi hanno osservato un miglioramento del metabolismo glucidico dopo l'intervento nei casi in cui il diabete aveva avuto una breve durata (inferiore ad un anno). La mortalità operatoria non differiva dalla mortalità dei non diabetici nel gruppo d'età fino a 60 anni, mentre nei pazienti più anziani la più alta mortalità era riferibile alle complicanze vascolari ed all'aumentata predisposizione alle infezioni.

     

Esophagectomy for cancer in octogenarians

Because of changes in life expectancy, there is an increasing number of elderly patients with esophageal cancer. The aim of this study was to assess the outcome of esophagectomy for cancer in patients 80 years or older. A retrospective review was performed of the records of all patients who underwent esophagectomy for cancer from 1992 to 2007. A cardiac and pulmonary evaluation was obtained on an individual basis in the younger patients and in all octogenarians. Among 560 patients with esophagectomy for cancer, 47 patients (8%) were octogenarians. The median age of the younger group (n= 513) was 63 years (interquartile range 56–71). Octogenarians had significantly more stage III disease (49% vs 31%, P= 0.02) but received less neoadjuvant therapy than younger patients (2% vs 21%, P= 0.0004). In octogenarians, the transhiatal resection was more common than in the younger group (79% vs 36%, P < 0.0001). Weight loss prior to surgery was similar in both groups, but body mass index was significantly lower in octogenarians (25 vs 28 kg/m², P= 0.0002). Major complications occurred in 26% in octogenarians and 31% in the younger group (P= 0.51). Hospital mortality was similar (9% for octogenarians vs 4% in the younger group, P= 0.13). The median postoperative hospital stay was similar at 16 days (P= 0.69). There was no difference in cancer‐related survival (median survival 48.9 vs 59.3 months, P= 0.31 log‐rank test). Esophagectomy can be performed safely in carefully selected octogenarians with good cardiac and pulmonary function. Patients should not be denied an esophagectomy based only on their age.