Cicenas Saulius, Stratilatovas Eugenijus, Miliauskas Povilas, Sangaila Egidijus, Piscikas Dainius Amerigas, Jakubauskiene Renata, Askinis Renatas, Zaremba Sigitas
Clinic of Surgery, Institute of Oncology, Vilnius University, Santariskiu 1, 2021 Vilnius, Lithuania.
Medicina (Kaunas). 2004;40 Suppl 1:179-82.
Objective of work was to evaluate efficacy of surgery for esophageal cancer with one-step gastric pipe reconstruction, to analyze postoperative complications, causes of deaths and patient's life expectancy. In 1992-2002 in Clinic of Surgery Vilnius University Institute of Oncology 213 patients underwent surgery for esophageal cancer; 177 patients (83.0%) were applied transthoracic approach, 34 patients (15.9%) transhiatal and 2 patients (0.9%) Lewis type operations. TNM of patients were T3N1M0 - 99 (46.4%), T2N1M0 - 17 (7.9%), T2N0M0 - 16 (7.5%), T4N2M0 - 54 (25.3%), T2-3N2M1 - 27 (12.6%). Patient performance status according to WHO scale was 0-2. The following postoperative complications were observed: vagus pneumonia - 52 (24.2%) patients, heart insufficiency- 13 patients (6.1%), aortal bleeding 3 (1.4%) patients, suture leakadge - 33 (15.4%) patients, injury of n. reccurentis 17 (7.9%) patients, pleurites 29 (13.6%). Postoperative mortality after transthoracic approach - 29.3%, transhiatal - 15%, Lewis resections - 0%. Median survival after transthoracic approach - 29 months, transhiatal - 34 months, Lewis resections - 39 months.
Surgery for esophageal cancer is the most sufficient way of esophageal cancer treatment. Three-level lymphadenectomies postpone early relapses. Postoperative mortality varies from 15 to 29.3%, median survival from 29 to 39 months.
本研究旨在评估采用一步法胃管重建术治疗食管癌的疗效，分析术后并发症、死亡原因及患者预期寿命。1992年至2002年期间，维尔纽斯大学肿瘤研究所外科诊所对213例食管癌患者实施了手术；177例患者（83.0%）采用经胸入路，34例患者（15.9%）采用经裂孔入路，2例患者（0.9%）采用Lewis术式。患者的TNM分期为：T3N1M0 - 99例（46.4%），T2N1M0 - 17例（7.9%），T2N0M0 - 16例（7.5%），T4N2M0 - 54例（25.3%），T2 - 3N2M1 - 27例（12.6%）。根据世界卫生组织（WHO）标准，患者的体能状态为0 - 2级。观察到以下术后并发症：迷走神经肺炎 - 52例（24.2%）患者，心力衰竭 - 13例患者（6.1%），主动脉出血3例（1.4%）患者，吻合口漏 - 33例（15.4%）患者，喉返神经损伤17例（7.9%）患者，胸膜炎29例（13.6%）。经胸入路术后死亡率 - 29.3%，经裂孔入路 - 15%，Lewis切除术 - 0%。经胸入路术后中位生存期 - 29个月，经裂孔入路 - 34个月，Lewis切除术 - 39个月。
手术是治疗食管癌最有效的方法。三级淋巴结清扫可延缓早期复发。术后死亡率在15%至29.3%之间，中位生存期在29至39个月之间。
