局部晚期食管癌伴胰腺侵犯行食管切除术加远端胰腺切除术后的长期生存：一例报告
Long-term survival after esophagectomy with distal pancreatectomy for locally advanced esophageal cancer with pancreatic invasion: a case report.
作者信息
Kaneko Yoshiki, Hisakura Katsuji, Ogawa Koichi, Akashi Yoshimasa, Ohara Yusuke, Owada Yohei, Enomoto Tsuyoshi, Furuya Kinji, Moue Shoko, Doi Manami, Takahashi Kazuhiro, Shimomura Osamu, Hashimoto Shinji, Sakamoto Noriaki, Maruyama Tsunehiko, Oda Tatsuya
机构信息
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Surgery, Mito Saiseikai General Hospital, 3-3-10, Futabadai, Mito, Ibaraki, 311-4145, Japan.
出版信息
Surg Case Rep. 2021 Dec 14;7(1):254. doi: 10.1186/s40792-021-01338-w.
BACKGROUND
The treatment for the locally advanced esophageal cancer invading adjacent organs is controversial. We performed a radical surgery for a patient suffering from lower esophageal cancer with pancreatic invasion, and led to long-term survival.
CASE PRESENTATION
A 62-year-old man with dysphagia, was endoscopically diagnosed lower esophageal cancer. Abdominal computed tomography shows that the tumor formed a mass with the solitary metastatic abdominal lymph node, which invaded pancreas body and gastric body. He was diagnosed locally advanced esophageal cancer cStage IIIC. As chemoradiotherapy was difficult because of the high risk of gastric mucosal damage, radical esophagectomy with distal pancreatectomy and reconstruction of gastric conduit were performed. The postoperative course was uneventful and the patient was discharged 16 days after operation. At present, 7 years after surgery, he is still alive with disease-free condition.
CONCLUSION
Esophagectomy with distal pancreatectomy may be feasible for locally advanced esophageal cancer with pancreatic invasion in terms of curability and long-term survival.
背景
局部进展期食管癌侵犯相邻器官的治疗存在争议。我们对一名患有侵犯胰腺的下段食管癌患者进行了根治性手术，并使其长期存活。
病例介绍
一名62岁吞咽困难男性，经内镜诊断为下段食管癌。腹部计算机断层扫描显示肿瘤形成肿块并伴有孤立性腹部转移淋巴结，侵犯胰体和胃体。他被诊断为局部进展期食管癌cⅢC期。由于胃黏膜损伤风险高，难以进行放化疗，遂行根治性食管切除术加远端胰腺切除术及胃管道重建术。术后过程顺利，患者术后16天出院。目前，术后7年，他仍存活且无疾病。
结论
对于侵犯胰腺的局部进展期食管癌，行食管切除术加远端胰腺切除术在可治愈性和长期生存方面可能是可行的。
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