食管癌外科治疗近期疗效的影响因素分析  

Surgical treatment effect in patients with esophageal carcinoma.

作　　者：朱琨[1] 党诚学[1] 李康[1] 孟磊[1] 陈武科[1] 

机构地区：[1]西安交通大学第一医院肿瘤外科,陕西西安710061

出　　处：《现代肿瘤医学》2006年第3期291-293,共3页Journal of Modern Oncology

摘　　要：目的 探讨食管癌患者年龄、吻合位置与术后并发症发生率和死亡率的关系，以及新辅助化疗对食管癌手术切除率的影响。方法 回顾性分析西安交通大学医学院第一医院肿瘤外科自1997年～2003年首诊收治、资料完整587例食管癌患者资料。结果 不同年龄组手术切除率分别为91．2％、95．9％和97．7％（P〉0．05）；〉70岁年龄组术后吻合口瘘发生率和术后死亡率均较其它组高（P〈0．05）。胸膜顶部吻合口瘘发生率为16．67％，较其它位置吻合口瘘发生率明显高（颈部2．17％、弓上1．09％、弓后2．60％、弓下0），具有显著性差异（P=0．019）。Ⅲ期食管癌患者行术前新辅助化疗组与未化疗组的手术切除率分别为96．92％和78．85％，具有显著差异（P〈0．05），而术后吻合口瘘发生率和术后死亡率无明显差异（P=1．000）。结论 术前新辅助化疗可提高食管癌手术的切除率并不增加术后并发症。年龄大并不完全是手术禁忌，高龄患者的手术应充分考虑患者的生理年龄。Objective To investigate the relationship between esophageal carcinoma patient＇s age, location of anastomotie, postoperative complications and mortality, and the neoadjuvant chemotherapy impact with the resection rates. Methods To retrospectively study the 587 eases of esophageal carcinoma who had been treated between 1997 and 2003. Results The reseet rates of patients in different age group were 91.2%, 95.9%, and 97.7%, respectively, the anastomotie leaks and mortality were higher in group over 70 - years - old than other groups （ P 〈 0.05 ）. Incidence of anastomotie leak at eupula pleurae was 16.67%, higher than other locations （ the neck 2.17%, the top of aortic arch 1.09%, back of aortic arch 2.60%, beneath aortic arch 0 ） , have statistical significant difference （ P = 0. 019）. For patients with Ⅲ stage esophageal carcinoma, reseet rates in neoadjuvant chemotherapy groups and non -neoadjuvant chemotherapy groups were 96.92% and 86.98%, respectively （ P 〈 0.05 ） , however, postoperative complications and mortality were not statistical significant （ P = 1. 00 ）. Conclusion Patients of esophageal carcinoma, neoadjuvant chemotherapy can increased the reseetability rate, meanwhile cannot increase postoperative complications and mortality. The patients＇physiological age shouid be considered to the eld patients in operation.

关 键 词：食管癌 新辅助化疗 并发症 外科治疗 

分 类 号：R735.1[医药卫生—肿瘤]