Kuwano H, Tsutsui S, Nagamatsu M, Ohno S, Matsuda H, Mori M, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1609-11.
We evaluated the effectiveness and complication of systematic lymph node dissection for the intrathoracic esophageal carcinoma, which includes cervical, intrathoracic and abdominal lymph node dissection. Two hundred and thirteen individuals with intrathoracic esophageal carcinoma underwent esophageal resection in the Department of Surgery II, Kyushu University from 1979 to 1988. Of these 213, systematic lymph node dissection in addition to esophageal resection was performed on 19 patients. Lymph node recurrence has been reduced with this procedure and survival rate was more favorable in the cases with systematic lymph node dissection than those without it at present. On the other hand, although the occurrence of postoperative recurrent nerve palsy in the cases with systematic lymph node dissection and in those without it were 47.4 and 11.9%, rates of postoperative pulmonary complications were 5.2 and 16.0%, respectively. Operative death was none in those with systematic lymph node dissection. Therefore, this procedure has been performed in safety with intensive perioperative cares and it would contribute more favorable prognosis.
我们评估了系统性淋巴结清扫术治疗胸段食管癌的有效性及并发症，该手术包括颈部、胸段及腹部淋巴结清扫。1979年至1988年期间，213例胸段食管癌患者在九州大学第二外科接受了食管切除术。其中19例患者除食管切除外还进行了系统性淋巴结清扫术。通过该手术，淋巴结复发率降低，目前系统性淋巴结清扫术患者的生存率比未进行该手术的患者更理想。另一方面，尽管系统性淋巴结清扫术患者和未进行该手术患者的术后喉返神经麻痹发生率分别为47.4%和11.9%，但术后肺部并发症发生率分别为5.2%和16.0%。系统性淋巴结清扫术患者无手术死亡病例。因此，通过围手术期的精心护理，该手术可安全实施，且有助于改善预后。
