Abstract: Objective To compare the feasibility and safety of inverted puncture and conventional intrathoracic anastomosis in esophagectomy in the elderly patients with esophageal cancer. Methods A retrospective study was conducted including 42 patients aged over 60 years old with esophageal cancer from January 2017 to January 2020. According to the different methods of thoracic anastomosis, 42 patients were divided into group A and group B with 21 case in each group. Group A was anastomosed by inverted puncture. Group B received routine anastomosis. The general data of patients before operation were collected, and the data of anastomotic time, anastomotic site, intraoperative bleeding, postoperative anastomotic complications and postoperative hospital stay were compared between the two groups. Results A total of 17 patients in group A successfully completed the operation. Four patients were transferred to surgery for various reasons. All the patients in group B completed smoothly. There were no significant differences in general data of sex and age between the two groups(P>0. 05). The anastomosis time was lower, and anastomotic site was higher in group A than those in group B (P<0. 05). There were no significant differences in the volume of intraoperative hemorrhage, postoperative hospitalization days and complications between the two groups (P> 0. 05). Conclusions Both inverted puncture and conventional thoracic anastomosis are feasible and safe.

Key words: esophageal cancer, minimal invasive, anastomosis, aged