Mansour K A, Picone A L, Coleman J J
Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Ann Thorac Surg. 1990 Apr;49(4):597-601; discussion 601-2. doi: 10.1016/0003-4975(90)90307-r.
The treatment of carcinoma of the cervical esophagus remains controversial. Eleven patients with carcinoma of the high cervical esophagus were encountered over the past 7 years at our institution. There were 6 men and 5 women whose ages ranged from 51 to 72 years. Six patients had tracheal or laryngeal invasion. In all instances one-stage pharyngolaryngoesophagectomy with pharyngogastric (6 patients) or pharyngocolic (5 patients) reconstruction was performed. There was one hospital death. Six patients died 6 to 35 months postoperatively: 1 from recurrence, 2 from generalized metastases, and 3 with both local recurrent and metastatic disease. One other patient died free of disease 6 weeks postoperatively of pneumonia. The remaining 3 patients are alive 12 to 84 months after operation with excellent rehabilitation and good quality of life. We conclude that one-stage surgical resection and reconstruction for high cervical carcinoma of the esophagus offers good palliation and possible long-term survival with acceptable operative risk.
颈段食管癌的治疗仍存在争议。在过去7年里，我们机构共收治了11例高位颈段食管癌患者。其中男性6例，女性5例，年龄在51岁至72岁之间。6例患者存在气管或喉侵犯。所有患者均接受了一期咽-喉-食管切除术，并采用咽-胃吻合术（6例）或咽-结肠吻合术（5例）进行重建。有1例患者在医院死亡。6例患者在术后6至35个月死亡：1例死于复发，2例死于全身转移，3例死于局部复发和转移。另有1例患者术后6周因肺炎死亡，死前无疾病复发。其余3例患者术后存活12至84个月，康复良好，生活质量高。我们得出结论，对于高位颈段食管癌，一期手术切除和重建可提供良好的姑息治疗效果，并有可能实现长期生存，且手术风险可接受。
