Okazumi S, Ochiai T, Shimada H, Matsubara H, Nabeya Y, Miyazawa Y, Shiratori T, Aoki T, Sugaya M
Department of Academic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Dis Esophagus. 2004;17(2):159-63. doi: 10.1111/j.1442-2050.2004.00379.x.
In order to minimize the invasiveness of the operative procedure for thoracic esophageal cancer, several procedures have been introduced since January 1997. They included: (i) perioperative use of steroids; (ii) muscle-sparing thoracotomy without costectomy; (iii) preparation of the gastric tube with preservation of sufficient blood supply; (iv) reconstruction of the alimentary tract via posterior-mediastinal route; and (v) formation of anastomosis between the remaining esophagus and the gastric tube at a location between the gastroepiploic arteries of the gastric greater curvature. Twenty-one patients who did not receive preoperative chemoradiotherapy underwent the newly developed procedure, and were compared with those receiving the original procedure. Hospital mortality was zero, and postoperative systemic inflammatory response syndrome was suppressed. The mean postoperative hospital stay was 21.5 days, and the actuarial 3-year survival rate was 76.2%. From the comparison with those receiving the original procedure, it can be concluded that the newly developed procedures were effective in minimizing surgical invasiveness and were sufficiently curative in terms of cancer treatment.
为了尽量减少胸段食管癌手术的侵袭性，自1997年1月起引入了几种手术方法。它们包括：（i）围手术期使用类固醇；（ii）不切除肋骨的保留肌肉开胸术；（iii）制备保留足够血供的胃管；（iv）经后纵隔途径重建消化道；以及（v）在胃大弯胃网膜动脉之间的位置将剩余食管与胃管进行吻合。21例未接受术前放化疗的患者接受了新开发的手术，并与接受原手术的患者进行了比较。医院死亡率为零，术后全身炎症反应综合征得到抑制。术后平均住院天数为21.5天，精算3年生存率为76.2%。通过与接受原手术的患者比较，可以得出结论，新开发的手术方法在尽量减少手术侵袭性方面是有效的，并且在癌症治疗方面具有足够的根治性。
