Imadahl A, Kirchner R, Swoboda L, Ruf G
Abteilung Allgemeine Chirurgie mit Poliklinik, Chirurgischen Universitätsklinik Freiburg.
Langenbecks Arch Chir. 1990;375(6):326-9.
Between 1980 and 1987 95 patients with esophageal carcinoma had a bronchoscopy. In 67 patients (70.5%) no pathological findings could be detected. In 24 patients (25.3%) signs of impingement were present and in 4 patients (4.2%) tumor infiltration into the tracheobronchial tree was visible. The correlation between tumor length and bronchoscopic findings revealed a marked increase of direct and indirect tumor evidence in esophageal carcinomas of more than 5 cm in length. Pathologic bronchoscopic findings were detected twice as often in patients with carcinoma of the upper third of the esophagus in comparison with those of the middle third. In 5 patients (5.3%) bronchoscopy revealed an unknown additional bronchial carcinoma. 67 of the 95 patients underwent operation. In 59 patients the esophagus was resected. Among the normal bronchoscopic findings the operability rate was 77.6%. In contrast, only half of the patients with pathological bronchoscopic findings were operable, the other patients received radiotherapy. We recommend, therefore, preoperative bronchoscopy as an important investigation for assessment of operability and for evaluation of synchronous neoplasms in patients with an esophageal carcinoma.
1980年至1987年间,95例食管癌患者接受了支气管镜检查。67例患者(70.5%)未发现病理结果。24例患者(25.3%)有受压迹象,4例患者(4.2%)可见肿瘤浸润至气管支气管树。肿瘤长度与支气管镜检查结果之间的相关性显示,长度超过5 cm的食管癌中,直接和间接肿瘤证据显著增加。与食管中段癌患者相比,食管上段癌患者病理支气管镜检查结果的检出率高出一倍。5例患者(5.3%)支气管镜检查发现了额外的未知支气管癌。95例患者中有67例接受了手术。59例患者进行了食管切除术。支气管镜检查结果正常的患者中,可手术率为77.6%。相比之下,支气管镜检查结果异常的患者中只有一半可进行手术,其他患者接受了放射治疗。因此,我们建议术前进行支气管镜检查,作为评估食管癌患者可手术性和同步性肿瘤的重要检查手段。