Carcinoma of the esophagus prevents swallowing, a function which surgery must restore whether the operation is curative or not. In the past, carcinomatous occlusion of the esophagus was looked upon as the "commencement de la fin," particularly in the patient who had reached the age of 75 or more. Palliative procedures, such as gastrostomy or jejunostomy, were done usually, and the patient was allowed to suffer through his last agonizing days.
We feel that a more aggressive attitude toward the management of esophageal carcinoma in the aged should be assumed. This concept is based upon the following premises: 1. The obstruction is as real in the old person as in the young. 2. The older person can ill afford to slowly starve, regurgitate, or aspirate because secondary changes supervene quickly. 3. Gastrostomy or other palliative procedures are poor substitutes for resections, since the patients continue with their dysphagia or aphagia.
BERMAN JK, LALONDE AH, FISHER C. Esophageal Carcinoma: Treatment in Patients of 75 to 85 Years of Age. Arch Surg. 1961;82(3):353–359. doi:10.1001/archsurg.1961.01300090023005
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