食管癌外科治疗经验

摘要

目的 回顾总结359例食管癌的外科治疗经验.方法 对所有病人的临床资料进行回顾性分析.结果 359例病人中,281例接受了根治性切除,59例行姑息行手术,12例接受了食管胃旁路手术,7例仅仅进行了剖胸探查术.6例术后病理证实为残端阳性,33例术后发生了并发症,其中12例术后死亡.结论 考虑到食管癌特殊的生物学特性,即便对那些晚期肿瘤我们也应该对其外科治疗持积极态度,术中尽可能多地切除食管和行冰冻切片检查有望避免残端阳性.临床需要采取各种措施来减少术后并发症,其中积极的术前准备有助于减少手术风险,机械吻合时采取一些特殊的手术技巧可望降低相关的并发症.%[Objective] To review and summarize the surgical experience of 359 patients with esophageal carcinoma. [Methods] 359 cases of pathologically confirmed esophageal carcinoma were involved in this report. Retrospective study was performed to analyse the clinical data. [Results] Of the 359 cases of treated patients, 281 underwent curative resection, 59 were treated with palliative surgery, 12 received bypass procedure, and the remaining received exploration thoractomy only; 6 cases were confirmed having tumor residue on the incision margin, 33 patients had complications, and 12 of them died postoperatively. [Conclusions] In view of special biologic character of esophageal carcinoma, we should have a positive attitude toward the surgical treatment of esophageal carcinoma.Resecting more esophagus and frozen section examination should be performed during operation to geta clean incision margin. Furthermore, attention must be paid to avoid surgical complications. Actively preoperative preparations could reduce the surgical risk and some special techniques have the potential to decrease the complications of staple anastomosis.