[食管癌：经胸食管切除术加区域淋巴结清扫及延期优先重建术]

[Esophageal carcinoma: transthoracic esophagectomy with regional lymphadenectomy and reconstruction with deferred priority].

作者信息

Siewert J R, Adolf J, Bartels H, Hölscher A H, Hölscher M, Weiser H F

出版信息

Dtsch Med Wochenschr. 1986 Apr 25;111(17):647-51. doi: 10.1055/s-2008-1068505.

DOI:10.1055/s-2008-1068505

Abstract

In a retrospective analysis the risks were assessed of transthoracic oesophagectomy with mediastinectomy and regional lymphadenectomy followed 48-72 hours later by an abdomino-cervical operation with supra-pancreatic lymphadenectomy, retrosternal gastric interposition and cervical oesophageal stump anastomosis. Results in this group of 37 patients were compared with those in a group of 42 patients who had undergone a transmediastinal oesophagectomy (without thoracotomy) and immediate reconstruction. The 30-day death rate was 8.1% in the former (group I) and 7.1% in the latter (group II), total hospital death rate 10.8% and 11.9%, respectively. The complication rate was similar in the two groups, as was the recorded operative stress. The results indicate that the risk of an oncologically indicated oesophagectomy with regional lymphadenectomy is no greater than that of a palliative transmediastinal oesophagectomy.

摘要

在一项回顾性分析中，评估了经胸食管切除术联合纵隔切除术及区域淋巴结清扫术的风险，48 - 72小时后再行腹颈联合手术，包括胰上淋巴结清扫术、胸骨后胃代食管术及颈段食管残端吻合术。将这组37例患者的结果与另一组42例接受经纵隔食管切除术（不开胸）并立即重建的患者的结果进行比较。前一组（I组）的30天死亡率为8.1%，后一组（II组）为7.1%，总住院死亡率分别为10.8%和11.9%。两组的并发症发生率相似，记录的手术应激情况也相似。结果表明，行肿瘤根治性食管切除术联合区域淋巴结清扫术的风险并不高于姑息性经纵隔食管切除术。