CAJ | 학술논문

目的探讨食管中下段癌同期放化疗后经左胸颈切除器械吻合的疗效.方法回顾性分析2000年1月至2011年12月解放军第一○五医院收治的86例食管鳞癌患者的临床资料.所有患者于术前放化疗后接受左胸颈两切口左颈部食管胃端侧器械吻合并行三野淋巴结清扫.术后通过门诊复查或每次入院定期复查进行随访,随访时间截至201 1年12月.采用Kaplan-Meier法计算生存率.结果 82例患者手术顺利,肿瘤切除率达95.3％ (82/86).82例患者AJCC分期Ⅱa期20例、Ⅱb期37例、Ⅲ期25例.术后病理检查结果证实淋巴结有转移者42例,分组标记证实颈、胸、腹3组淋巴结转移率分别为3.7％ (3/82)、53.7％ (44/82)、22.0％ (18/82).86例患者并发症发生率为13.4％ (11/82),死亡1例.74例患者随访4个月至10年,中位随访时间为7.6年.19例Ⅱa期患者术后1、3、5年生存率分别为88％、83％、57％,34例Ⅱb期患者分别为82％、68％、43％,21例Ⅲ期患者分别为56％、25％、16％.结论食管中下段癌放化疗后经左胸颈切除器械吻合具有病灶切除彻底,切缘癌细胞残留率低,严重并发症少,近期疗效好的优点.
목적 탐토식관중하단암동기방화료후경좌흉경절제기계문합적료효.방법 회고성분석2000년1월지2011년12월해방군제일○오의원수치적86례식관린암환자적림상자료.소유환자우술전방화료후접수좌흉경량절구좌경부식관위단측기계문합병행삼야림파결청소.술후통과문진복사혹매차입원정기복사진행수방,수방시간절지201 1년12월.채용Kaplan-Meier법계산생존솔.결과 82례환자수술순리,종류절제솔체95.3％ (82/86).82례환자AJCC분기Ⅱa기20례、Ⅱb기37례、Ⅲ기25례.술후병리검사결과증실림파결유전이자42례,분조표기증실경、흉、복3조림파결전이솔분별위3.7％ (3/82)、53.7％ (44/82)、22.0％ (18/82).86례환자병발증발생솔위13.4％ (11/82),사망1례.74례환자수방4개월지10년,중위수방시간위7.6년.19례Ⅱa기환자술후1、3、5년생존솔분별위88％、83％、57％,34례Ⅱb기환자분별위82％、68％、43％,21례Ⅲ기환자분별위56％、25％、16％.결론 식관중하단암방화료후경좌흉경절제기계문합구유병조절제철저,절연암세포잔류솔저,엄중병발증소,근기료효호적우점.
Objective To investigate the efficacy of resection and stapler anastomosis via left cervicothoracic approach for the treatment of distal esophageal cancer.Methods The clinical data of 86 patients with esophageal squamous cell carcinoma who were admitted to the No.105 Hospital of PLA were retrospectively analyzed.All patients received preoperative radiochemotherapy followed by radical esophagectomy and esophagogastric end-to-side anastomosis via left cervicothoracic approach.All the patients were followed up via outpatient examination till December 2011.The survival rate was calculated by Kaplan-Meier method.Results The surgery was successfully carried out on 82 patients,and the resection rate was 95.3％ (82/86).According to AJCC staging,there were 20 patients in stage Ⅱ a,37 patients in stage Ⅱ b,25 patients in stage Ⅲ.Forty-two patients were diagnosed with lymph node metastasis,and the metastatic rates of lymph nodes in the neck,chest and abdomen were 3.7％ (3/82),53.7％ (44/82) and 22.0％ (18/82),respectively.The complication rate was 13.4％ (11/82),and 1 patient died postoperatively.The 1-,3-,5-year survival rates were 88％,83％ and 57％for patients in stage Ⅱ a,82％,68％ and 43％ for patients in stage Ⅱ b,56％,25％ and 16％ for patients in stage Ⅲ.Conclusions Resection and stapler anastomosis via left cervicothoracic aproach for the treatment of distal esophageal cancer has the advantages of low complication rate,high resection rate and excellent curative effect.