CAJ | 학술논문

目的探讨早期颈段食管癌局部切除加食管端端吻合治疗方式的可行性.方法 7例患者经胃镜证实为颈段食管鳞癌,病灶距门齿17～20 cm；病灶1.0～2.5 cm,均未侵及食管纵行肌层,术前PET/CT和胸部增强CT检查均未发现有胸内和颈部淋巴结转移征象,cT1-2N0M0.手术切缘距病灶≥1cm,切除范围3～5 cm,同时清扫颈部淋巴结,平均6.43枚/例,术后颈部石膏托固定,以防止吻合口张力.术后辅助放、化疗.结果术后无严重并发症发生,平均住院14.5天.均健在,最长随访3年4个月,能进普食,无吻合口狭窄.结论早期颈段食管癌局部切除加食管端端吻合大大减少手术创伤,提高患者生活质量,使患者能更好的接受术后辅助治疗,对早期颈段食管癌是一种可行、有效的治疗模式.
목적 탐토조기경단식관암국부절제가식관단단문합치료방식적가행성.방법 7례환자경위경증실위경단식관린암,병조거문치17～20 cm；병조1.0～2.5 cm,균미침급식관종행기층,술전PET/CT화흉부증강CT검사균미발현유흉내화경부림파결전이정상,cT1-2N0M0.수술절연거병조≥1cm,절제범위3～5 cm,동시청소경부림파결,평균6.43매/례,술후경부석고탁고정,이방지문합구장력.술후보조방、화료.결과 술후무엄중병발증발생,평균주원14.5천.균건재,최장수방3년4개월,능진보식,무문합구협착.결론 조기경단식관암국부절제가식관단단문합대대감소수술창상,제고환자생활질량,사환자능경호적접수술후보조치료,대조기경단식관암시일충가행、유효적치료모식.
Objective To investigate the feasibility of treatment mode of end-to-end anastomosis of esophagus(EAS) af ter partial resection for early-stage cervical esophageal carcinoma(ECEA).Methods 7 patients were substantially confirmed as squsmous cell carcinoma of cervical esophagus by endoscopy,the nearest distance of the lesion from the incisors was 17cm,and the furthest was 20 cm,the maximum extent was 2.5 cm,and the minimum was 1 cm.None of them with longitudinal muscularis invasion.Confirmed by PET/CT or chest enhancement CT examination preoperatively,intrathoracic and cervical lymphatic metastasis was excluded,cT1 -2 N0 M0.Incisal margin length was not less than 1 cm,the maximum was 5 cm and the minimum was 3 cm.Meanwhile,the cervical lymph node should be dissected,and the average number was 6.43 per case.After surgery,all the patients were fixed by plaster slab to release the tension of anastomosis.Postoperative adjuvant radiotherapy or chemotherapy was received.Results None of the patients had severe postoperative complications,and the average hospital stay was 14.5 days.All the patients are alive,the longest follow-up lasts for 3 years and 4 months,all of them can take normal food,without anastomotic stenosis.Conclusion Treatment mode of EAS after partial resection for ECEA significantly decrease the operative damage,apparently improve the patient's quality of life(QOL),so that the patients can better receive adjuvant treatment subsequently; it is a feasible and effective method for cervical esophageal carcinoma at the early stage.