CAJ | 학술논문

目的评价经裂孔食管切除术在食管癌外科治疗中的作用.方法总结分析2000年5月至2007年7月单一外科医生组对46例食管癌患者实施经裂孔食管切除术的病例资料.结果本组患者食管鳞癌44例,食管腺癌1例.食管类癌1例.位于颈段者11例,胸上段者21例,胸中段者5例,胸下段者9例.行术前化疗者6例.按国际TNM分期:0期者3例;Ⅰ期者6例;Ⅱ a期者17例;Ⅱb期者2例;Ⅲ期者16例;2例为化疗后病理完全缓解.胃代食管者42例,结肠代食管者4例.术前肺功能FEV1低于0.8 L或FEV1/FVC低于50%者29例.46例均获切除,切缘阴性,无手术死亡.术后声音嘶哑2例,心律失常3例.双侧胸腔积液1例,6例出现小的颈部吻合口瘘.结论经裂孔食管切除术在食管癌的外科治疗中对高龄、心肺功能差而不能耐受剖胸手术患者是理想的选择.
목적 평개경렬공식관절제술재식관암외과치료중적작용.방법 총결분석2000년5월지2007년7월단일외과의생조대46례식관암환자실시경렬공식관절제술적병례자료.결과 본조환자식관린암44례,식관선암1례.식관유암1례.위우경단자11례,흉상단자21례,흉중단자5례,흉하단자9례.행술전화료자6례.안국제TNM분기:0기자3례;Ⅰ기자6례;Ⅱ a기자17례;Ⅱb기자2례;Ⅲ기자16례;2례위화료후병리완전완해.위대식관자42례,결장대식관자4례.술전폐공능FEV1저우0.8 L혹FEV1/FVC저우50%자29례.46례균획절제,절연음성,무수술사망.술후성음시아2례,심률실상3례.쌍측흉강적액1례,6례출현소적경부문합구루.결론 경렬공식관절제술재식관암적외과치료중대고령、심폐공능차이불능내수부흉수술환자시이상적선택.
Objective To evaluate the transhiatus esophageetomy for patients with esophageal cancer.Methods Clinieopathological data of 46 patients with esophageal cancer undergone transhiatus esophagectomy by single surgeon team from May 2000 to July 2007 were analyzed retrospectively.Results These 46 patients included 44 esophageal squamous cell carcinomas,1 esophageal edenocarcinoma and 1 esophageal carcinoid.The lesions of 11 patients located at neck segment,21 at upper segment,5 at middle segment,and 9 at lower segment.All the patients were classified according to UICC TNM stage classification:3 cases as stage 0,6 cases as stage Ⅰ ,17 cases as stage Ⅱ a,2 cases as stage Ⅱ b,16 cases as stage Ⅲ. Six patients received preoperative chemotherapy and pathological complete response was seen in 2 cases. Reconstruction with stomach was performed in 42 cases and with colon interposition in 4 cases.All the tumors were reseeted, and there was no perioperative death. All the resected margins were pathologically clear. Postoperative complications occurred in 12 cases and were successfully treated, including 2 cases of hoarseness, 3 cases of cardiac arrhythmia,1 case of bilateral pleural effusion, and 6 cases of small anastomotic leakage at neck. Conclusion Transhiatus esophagectomy is an ideal choice in surgical treatment for patients with esophageal cancer,especially for the ones of aged,poor cardiac or pulmonary function,who can not afford the thoracotomy.