CAJ | 학술논문

目的：总结选择性颈胸腹三野淋巴结清扫治疗胸段食管癌的临床经验与意义。方法收集2006年1月至2013年2月于我科行食管次全切除并选择性颈胸腹三野淋巴结清扫治疗的62例胸段食管癌患者，其中男34例，女28例，年龄38~81岁；上段食管癌24例，中段食管癌28例，下段食管癌10例；术后病理报告：鳞状细胞癌59例，鳞腺癌2例，腺癌1例。结果55例患者获根治性切除，围手术期死亡1例；术后并发症发生率为51.61%。本组病例中颈部、上纵隔淋巴结转移率分别为87.09%、79.03%。随访6个月至5年，死亡13例，10例已存活5年。吻合口肿瘤复发3例。结论选择性三野根治术治疗胸段食管癌可提高肿瘤根治率，减少肿瘤局部复发。通过选择和防治，不增加手术并发症和病死率。
목적：총결선택성경흉복삼야림파결청소치료흉단식관암적림상경험여의의。방법수집2006년1월지2013년2월우아과행식관차전절제병선택성경흉복삼야림파결청소치료적62례흉단식관암환자，기중남34례，녀28례，년령38~81세；상단식관암24례，중단식관암28례，하단식관암10례；술후병리보고：린상세포암59례，린선암2례，선암1례。결과55례환자획근치성절제，위수술기사망1례；술후병발증발생솔위51.61%。본조병례중경부、상종격림파결전이솔분별위87.09%、79.03%。수방6개월지5년，사망13례，10례이존활5년。문합구종류복발3례。결론선택성삼야근치술치료흉단식관암가제고종류근치솔，감소종류국부복발。통과선택화방치，불증가수술병발증화병사솔。
Objective To summarize the clinical experience and significance of subtotal esophagectomy with three-field lymphadenectomy for the treatment of thoracic esophageal carcinoma. Methods The data of 62 patients,averagely aged 57.8 years, with thoracic esophageal carcinoma of our department from Jan.2006 to Feb.2013 were analyzed. In which were 34 men and 28 women.The number of the tumor located at upper, middle and lower segment was 24, 28 and 10 cases respectively. 59, 2 and 1 patients were pathologically diagnosized with squamous cell carcinoma adeno-squamous and adenocarcinoma after surgery respectively. Results 55 cases underwent radical resection, 51.61%cases developed postoperative complications. The transfer rate of lymph node in cervix、upper-mediastinum were 87.09%、79.03%respectively. All patients were followed up for 6 months to 5 years, with 13 cases died and 10 cases recurrence. Conclusion It is feasible to treat esophageal carcinoma by subtotal esphagectomy with selective 3-field lymphadenectomy. This procedure can reduce the relapse and completely clear the positive lymph nodes.