Kubo Naoshi, Tanaka Hiroaki, Sakurai Katsunobu, Muguruma Kazuya, Nagahara Hisashi, Kimura Kenjiro, Noda Eiji, Amano Ryosuke, Yamada Nobuya, Yashiro Masakazu, Maeda Kiyoshi, Ohira Masaichi, Hirakawa Kosei
Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2011 Nov;38(12):1948-50.
Recently, the number of patients undergoing definitive chemoradiotherapy (CRT) for not only incurable esophageal carcinoma, but also resectable tumor has increased. Accordingly, salvage surgery has been conducted for residual or relapsed tumor after definitive CRT. We compared the surgical outcome of 7 cases undergoing salvage esophagectomy (SE) in our hospital, with those of planned CRT( in which 40 Gy external beam was radiated) followed by surgery (PS) and surgery alone (SA). Anastomotic leakage rate of SE (43%) was significantly higher than that of PS (3%) and SA (7%). Respiratory complication rate of SE was higher than that of PS and SA, but not significantly. Hospital mortality rate of SE was 28% and that rate increased in proportion to radiated dose. Salvage surgery should be performed for patients in which complete resection of esophageal cancer could be achieved because of its high rate of mortality and morbidity.
最近，不仅是无法治愈的食管癌，可切除肿瘤接受根治性放化疗（CRT）的患者数量也有所增加。因此，对于根治性CRT后残留或复发的肿瘤已开展挽救性手术。我们比较了我院7例行挽救性食管切除术（SE）的患者与计划性CRT（外照射40 Gy）后手术（PS）及单纯手术（SA）患者的手术结果。SE的吻合口漏发生率（43%）显著高于PS（3%）和SA（7%）。SE的呼吸并发症发生率高于PS和SA，但差异无统计学意义。SE的医院死亡率为28%，且该比率与照射剂量成正比。由于死亡率和发病率较高，挽救性手术应仅用于能够实现食管癌完全切除的患者。
