Hurley J P, Keeling P
Department of Surgery, University College Hospital, Galway.
Ir Med J. 1990 Mar;83(1):23-5.
All patients presenting to a regional unit with oesophageal carcinoma over a twelve month period are reviewed and the role of transhiatal oesophagectomy for tumours of the middle third of the intrathoracic oesophagus is evaluated. Of the 28 cases of oesophageal carcinoma, 22 (78%) were resected by blunt transhiatal oesophagectomy, the remaining six (22%) has various forms of palliative treatment. In the resected group post-operative morbidity was compared in patients with tumours of the middle third to those with lower and upper third tumours combined. There was one post-operative death in each group giving an overall operative mortality of 9%. Resection for carcinoma of the middle third (N = 7) resulted in a complication rate of 50% and a mean ICU stay of 19.5 days as opposed to a complication rate of 35% and a mean ICU stay of ten days (P = 0.050) for tumours of upper and lower third combined (N = 15). On the basis of these figures we question whether transhiatal oesophagectomy, despite its many advantages, can be applied safely to tumours of the middle third of the intrathoracic oesophagus.
对在十二个月期间到某地区单位就诊的所有食管癌患者进行了回顾，并评估了经裂孔食管切除术对胸段食管中三分之一肿瘤的作用。在28例食管癌病例中，22例（78%）通过钝性经裂孔食管切除术切除，其余6例（22%）接受了各种形式的姑息治疗。在切除组中，将胸段食管中三分之一肿瘤患者与下三分之一和上三分之一肿瘤合并患者的术后发病率进行了比较。每组各有1例术后死亡，总体手术死亡率为9%。胸段食管中三分之一癌切除术（N = 7）的并发症发生率为50%，平均重症监护病房（ICU）住院时间为19.5天，而上三分之一和下三分之一肿瘤合并切除术（N = 15）的并发症发生率为35%，平均ICU住院时间为10天（P = 0.050）。基于这些数据，我们质疑经裂孔食管切除术尽管有许多优点，但能否安全地应用于胸段食管中三分之一的肿瘤。
