食管癌术后局部复发的外科治疗  

Surgical treatment for recurrent carcinoma of the esophagus

作　　者：陈建华[1] 王彤[1] 胡夏荣[1] 何广宁[1] 

机构地区：[1]广东省东莞市人民医院肿瘤外科,广东东莞523018

出　　处：《海南医学》2006年第4期34-35,共2页Hainan Medical Journal

摘　　要：目的探讨食管癌手术后复发的诊断和再手术适应证的选择。方法回顾性分析48例食管癌术后复发患者再次手术治疗的结果。结果48例中切除36例,切除率75%。术后发生各类并发症8例次,发生率为22.2%,手术死亡3例,手术死亡率8.3%。病理证实吻合口复发28例,残留食管再发癌6例,癌残留复发侵及胸胃2例。根治性切除28例,姑息性切除8例。术后生存5年以上8例,3年以上10例,1年以上7例,8例分别在1年及1年内死亡;探查者12例分别于术后6～15个月内死亡。结论对食管癌术后复发者,若病变未侵及动脉或气管,放疗后病变缩小,无远处转移,且心肺功能可以耐受手术者,外科手术仍是首选治疗方法。objective To review the surgical operation indication and the diagnosis of reopemtion for recurrent carcinoma of the esophagus. Methods 48 patients with local recurrence of esophageal cancer were reopcrated and analysed retrospectively. Results The resectability rate was 75%（36/48） and the hospital mortality rate was 8.3%（3/48）. Postoperative complications occurred in 8 patients with a morbidity of 22.2%. pathologically, previous anastomotic relapse was seen in 28 patients, recurrent lesion of residual esophagus in 6, and recurrent cancerous residue at the esophageal bed in 2. Curative resection was performed for 28 patients and palliative resection for 8 patients. Follow-up showed that 8 patients survived for 5 years, 10 for 3 years, and 7 for 1 year. 8 patients died within one year after reoperation. Conclusions The recurrence of esophageal cancer after first operation is not a eontmindication to reoperation, but careful preoperative assessment and patients＇ selection should become an integral part of the evaluation of these patients. Reoperatian is the first choice for patients with local recurrence of esophogeal cancer.

关 键 词：食管癌 局部复发 外科治疗 

分 类 号：R735.1[医药卫生—肿瘤]