CAJ | 학술논문

目的总结90例早期贲门腺癌外科切除治疗的经验和远期效果.方法 1972年至1997年间,对组织病理检查诊断为早期贲门腺癌的90例患者行外科手术切除治疗.手术经左侧开胸,行包括部分胃和食管的贲门切除术,食管胃主动脉弓下吻合术和胸腹腔局部淋巴结清扫术.结果肿瘤切除率100%,术后死亡率1.1%(1/90),术后并发症发生率为4.4%(4/90).手术切除标本病理检查发现:黏膜内癌46例(51.1%),无淋巴结转移;黏膜下浸润癌44例(48.9%),淋巴结转移5例(11.4%).所有患者随访至2002年,其间失访7例,其总体5、10、15、20和25年生存率分别为91.9%、83.6%、69.6%、49.8%和16.6%.结论为提高胃贲门癌生存率,早期诊断和早期治疗是最佳途径.早期贲门癌外科切除治疗可提供很好的长期生存效果.
목적 총결90례조기분문선암외과절제치료적경험화원기효과.방법 1972년지1997년간,대조직병리검사진단위조기분문선암적90례환자행외과수술절제치료.수술경좌측개흉,행포괄부분위화식관적분문절제술,식관위주동맥궁하문합술화흉복강국부림파결청소술.결과 종류절제솔100%,술후사망솔1.1%(1/90),술후병발증발생솔위4.4%(4/90).수술절제표본병리검사발현:점막내암46례(51.1%),무림파결전이;점막하침윤암44례(48.9%),림파결전이5례(11.4%).소유환자수방지2002년,기간실방7례,기총체5、10、15、20화25년생존솔분별위91.9%、83.6%、69.6%、49.8%화16.6%.결론 위제고위분문암생존솔,조기진단화조기치료시최가도경.조기분문암외과절제치료가제공흔호적장기생존효과.
Objective To summarize therapeutic experience and the long-term results of early cardiac adenocarcinoma with surgical resection. Methods Ninety cases were diagnosed with early cardiac adenocarcinoma during endoscopic screening in high incidence rate area of esophageal cancer from 1972 to 1997. All of the patients accepted surgical treatment. Cardiectomy included partial stomach and esophagus was performed through left thoracotomy in all patients. Esophagogastrostomy was carried out in the infra-aortic region and thoracoabdominal lymphatic dissection was performed in all cases. Results The resection rate was 100%. One patient died in one month after the operation. Postoperative complications occurred in 4 cases (4.4%). Pathological examination of cancer specimens showed that 46 cases (51.1%) were intramucosal carcinoma without lymphatic metastasis and 44 cases (48. 9% ) were submucous infiltrating carcinoma with lymphatic metastasis in 5 ( 11.4% ). The patients were followed-up to 2002, and the overall 5, 10, 15, 20 and 25 year survival rates were 91.9%, 83.6%, 69.6%, 49.8% and 16.6%,respectively. Conclusions Early diagnosis and early treatment may be the best approach for promoting the survival of the cardiac cancer. Surgical resection of early cardiac carcinoma provides excellent long-term survival.