食管平滑肌瘤的外科治疗(附32例报告)  

The Surgical Therapy of Oesophageal Leiomyoma(32 cases reports)

作　　者：韩洪利[1] 王学勤[1] 韩庆良[1] 

机构地区：[1]天津市胸科医院胸外科,天津市300051

出　　处：《中国肿瘤临床》2006年第15期894-896,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨食管平滑肌瘤的诊断、治疗方法及其疗效。方法:分析手术治疗32例食管平滑肌瘤的临床资料。结果:单发型30例,多发型2例。肿瘤位于食管上段2例,中段27例,下段3例。行粘膜外肿瘤摘除术28例次,肿瘤及部分食管切除、食管胃主动脉弓上吻合术2例,弓下吻合术3例,肿瘤恶变后探查1例。手术切口为颈部切口3例次,右开胸20例,左开胸11例。本组病例无围手术期死亡。术后随访3年至10年,除1例肿瘤恶变者在术后5年死亡外,其他病例均生存。结论:手术切除是治疗食管平滑肌瘤唯一有效的方法,多数病例可行粘膜外肿瘤摘除术,少数肿瘤巨大或多发者需行肿瘤及部分食管切除、胃食管吻合术。如术后肿瘤复发需考虑肿瘤恶变。Objective： To analyze the diagnosis, therapy and curative effect of oesophageal leiomyoma. Methods： The clinical data for 32 cases of oesophageal leiomyoma, treated with surgical therapy, were studied. Results： Thirty cases with solitary tumors and 2 with multiple tumors were found. According to the position, 2 cases were at the upside of oesophagus, 27 at the midpiece and 3 at inferior segment. Extra-mucosal excision were conducted in 28 cases. Esophagogastrostomy at superior aortic arch were conducted in 2 cases and that at inferior aortic arch were done in 3. The exploration after canceration of tumors was performed in 1 case. As for the operative incision, 3 cases or times were at the cervical part, 20 at right opened thorax and 11 at left opened chest. No peri-operative death were reported in the cases of the group. Postoperative follows up had been performed for 3 to 10 years. The results showed that all the patients survived except 1 case of post-treatment death within 5 years. Conclusions： Surgical is the only effective method to cure oesophageal leiomyoma. Extra-mucosal tu- mor extirpation can be performed in most cases, however, excision on tumors or part of esophagus and anastomosis between stomach and oesophagus in a few cases with tremendous or multiple tumors is needed. The canceration of tumors should be first considered in case of postoperative relapse.

关 键 词：食管平滑肌肿瘤 外科治疗 疗效 

分 类 号：R735.1[医药卫生—肿瘤]