Background and purpose: The incidence rate of elderly esophageal carcinoma patients is increasing year by year. In this study

the clinicopathologic factors

operational factors and postoperative complications were compared between the older and the younger elderly patients with thoracic esophageal squamous cell carcinoma (ESCC)

and the influence of different surgical approaches to older elderly patients were analyzed. Methods: A retrospective review of 371 cases of elderly patients with thoracic esophageal squamous cell carcinoma (≥60 years) between Jan. 2006 and Dec. 2008 were performed. The patients were divided into two age groups. The patients over 75 years old named the older elderly group including 53 patients

and the patients between 60-74 years named the younger elderly group including 318 patients

the clinicopathological factors

operational factors

postoperative hospital mortality and average length of stay were compared. Meanwhile

according to different surgical approaches

the comparison of the left chest and right chest approach of operative time

blood loss and postoperative complication rate

and so on and so forth. Results: The older elderly group compared with the younger elderly group had more preoperative complications. Preoperative ASA classification and postoperative complications

length of stay and hospital mortality rates were significantly higher. The older elderly group over the right chest approach had less postoperative complications

especially pulmonary complications

the results were statistically significant.(13.0% vs 40.0%，P0.05) Conclusion: The patients over 75 years old with thoracic esophageal squamous cell carcinoma have a higher risk during the operation

we can choose relatively simpler operation approach to reduce the incidence of postoperative complications

especially pulmonary complications.