Esophageal cancer is a disease with difficult clinical management, and palliative therapy is the only predominant treatment. This retrospective study analyses the results of clinical management of elderly patients (>75 years of age) who were treated with esophageal stenting for malignant dysphagia due to primary esophageal cancer, including squamous cell carcinoma (SCC), esophageal adenocarcinoma (EAC), as well as secondary esophageal malignant strictures due to non-small cell lung cancer (NSCLC). Patients with esophago-respiratory fistula (ERF) were also included in the study. This study included 166 patients aged 75–88 (mean age, 78) years. Nine (5.4%) patients had upper malignant esophageal stenosis, 48 (28.1%) had the middle, 43 (25.9%) in the lower part of the esophagus, 49 (29.5%) patients had EAC-related stenosis, and 17 (10.2%) patients reported lung cancer-related esophageal stenosis. Dysphagia was rated at 2.8 (range, 2–3) before stenting and at 1.2 (range, 1–2) after the stenting procedure. Seven (4%) patients experienced stenting migration, 12 (7.2%) had granulation tissue overgrowth and prosthesis obstruction, two (1.2%) developed respiratory failure, and one (0.6%) patient died. Twelve (7.2%) patients were treated for ERF with double-stenting, and three (1.8%) patients developed a secondary fistula after the stent implantation. The mean survival of patients with esophageal cancer and ERF was 101.8 days and 62.5 days, respectively. Esophageal stenting has proven a safe procedure in patients over 75 years of age. It has a low rate of stenting obstruction and migration. Patients with ERF are a particularly difficult group to treat, show very poor outcomes and short survival rates.

Zenker’s diverticulum is a cause of benign dysphagia. The main symptoms include dysphagia and regurgitation and require diagnostics to exclude neoplastic disease. Surgical treatment is recommended for symptomatic patients. The methods of treatment include endoscopic and open transcervical techniques. Thirty-eight patients treated using the open technique between 2000 and 2020 were analyzed. Patients were qualified for the procedure after a complete diagnosis that excluded the neoplastic process. All patients were assessed for the degree of dysphagia, weight loss, and comfort after surgery. All patients underwent a transcervical diverticulum resection with a myotomy of the cricopharyngeal muscle for a minimum length of 3 cm. After surgery, the patients showed improvement in swallowing and could be fed orally; their diet was complete. One patient (2.6%) had an esophageal fistula which was successfully treated conservatively, two patients (5.2%) required reoperation due to postoperative bleeding, and two patients (5.2%) experienced temporary laryngeal nerve palsy. One patient required retreatment due to recurrent diverticula 20 months after the surgery. There was no death in the perioperative period. ‘Very good’ long-term functional results were obtained in 27 (71.1%) patients, ‘good’ in eight (21.1%), and ‘bad’ in three (7.9%). The traditional open technique of treating cervical diverticula of the esophagus is safe for older patients, has an acceptable percentage of postoperative comorbidity, and yields good functional results.