Pirogov A I, Nered S N
Grudn Khir. 1989 Sep-Oct(5):69-74.
The authors analyse 100 operations for resection of the esophagus after radiotherapy. Morphological examination before irradiation showed squamous cell carcinoma in all patients. Difficulties arise in the diagnosis of a residual esophageal tumor after radiotherapy, as a result of which 11 (14.5%) of 76 patients irradiated with a dose of 30-40 GY and 1 (4.2%) of 24 patients who received a dose of 50-70 Gy were exposed to the risk of a surgical intervention in the absence of morphological signs of a tumor in the removed esophagus. The difficulties of the diagnosis are due to resorption of the tumor under the effect of radiotherapy, its exophytic component in particular, the frequent submucosal position of the tumor, signs of therapeutic pathomorphosis of the tumor, and fibrosis of the esophageal wall.
作者分析了100例放疗后食管切除术。放疗前的形态学检查显示所有患者均为鳞状细胞癌。放疗后残留食管肿瘤的诊断存在困难，因此，在76例接受30-40GY剂量照射的患者中，有11例（14.5%），在24例接受50-70GY剂量照射的患者中，有1例（4.2%），在切除的食管中没有肿瘤形态学迹象的情况下面临手术干预的风险。诊断困难的原因在于放疗作用下肿瘤的吸收，尤其是其外生性成分，肿瘤常见的黏膜下位置，肿瘤治疗性病理形态改变的迹象以及食管壁的纤维化。
