保留喉功能的非开胸食管钝性剥脱术治疗颈段食管癌  

Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation

作　　者：王文光[1] 李进东[1] 许金良[1] 高宗人[1] 邵令方[1] 

机构地区：[1]河南省肿瘤医院胸外科,郑州450008

出　　处：《中华胃肠外科杂志》2007年第2期124-126,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨保留喉功能的非开胸食管钝性剥脱术治疗颈段食管癌的临床经验。方法总结分析1997年8月至2005年11月间，采用保留喉功能非开胸食管钝性剥脱术对28例颈段食管癌患者进行治疗的临床资料。结果28例患者术前均确诊为颈段食管鳞状细胞癌。其中12例单纯接受手术治疗（单纯手术组），16例术前或术后接受放疗（综合治疗组）。治疗期间，全组无1例发生大出血、气管撕裂及围手术期死亡；6例（21．4％）出现并发症，其中吻合口瘘2例，喉返神经损伤4例。全组患者5年总体生存率50．3％；单纯手术组5年生存率25．7％，综合治疗组5年生存率66．1％；综合治疗组明显优于单纯手术组Χ^2=4．07，P=0．0438）。结论保留喉功能的非开胸食管钝性剥脱术治疗颈段食管癌是可行的，联合放射治疗可以明显提高患者的术后生存率。Objective To study the feasibility and effect of Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation. Methods The data of 28 patients with cervical esophageal carcinoma, collected from Aug. 1997 to Nov. 2005, were investigated retrospectively. Results All the 28 patients were diagnosed as cervical esophageal squamous cell carcinoma. Among them, 12 patients underwent surgery （surgery group）, while the other 16 patients underwent surgery plus radiation therapy preoperatively or postoperatively （muhimodality therapy group）. No uncontrolled intraoperative and postoperative hemorrhage and tracheal tear occurred. The incidence of complications was 21.4% （6/28）, including cervical anastomotic leakage in 2 patients and recurrent laryngeal nerve injury in 4 patients. The overall 5-year survival rate was 50.3%. The 5-year survival rate was 25.7% in surgery group and 66.1% in muhimodality therapy group, and the difference between two groups was statistically significant （Χ^2=- 4.07 ;P=0.0438）. Conclusions Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with larynx function preservation is possible. Combined with radiotherapy preoperatively or postoperatively, the survival time in patients with cervical esophageal carcinoma is able to be prolonged.

关 键 词：食管肿瘤 颈段 食管剥脱术 食管成形术 

分 类 号：R735[医药卫生—肿瘤]