Sugimachi K, Kitamura M, Ueo H, Tamada R, Inokuchi K
Jpn J Surg. 1985 May;15(3):190-4. doi: 10.1007/BF02469885.
Since the late 1970's, there has been a remarkable decrease in the mortality of patients with esophageal cancer. Factors such as progress in pre- and post-operative management, operative technique, and anesthesia all play a contributory role in this improvement. Among 251 Japanese patients with esophageal carcinoma who underwent esophageal resection and reconstruction in our department of surgery since 1965, those treated from 1965-74 and others treated from 1975-1984 were investigated in detail. It became clear that pulmonary complications and anastomotic leakage were the two major complications related to operative mortality. The former has decreased by intensive postoperative care with strong emphasis on cough dynamics, and the latter because of the long gastric tube we devised and which has a good blood supply. These positive events make feasible early postoperative irradiation and cancer chemotherapy.
自20世纪70年代末以来，食管癌患者的死亡率显著下降。术前和术后管理、手术技术及麻醉等方面的进步均在这一改善过程中发挥了作用。自1965年以来，在我们外科接受食管切除和重建手术的251例日本食管癌患者中，对1965年至1974年期间治疗的患者以及1975年至1984年期间治疗的其他患者进行了详细调查。结果表明，肺部并发症和吻合口漏是与手术死亡率相关的两大主要并发症。前者通过强调咳嗽动力的强化术后护理而减少，后者则得益于我们设计的具有良好血供的长胃管。这些积极进展使术后早期放疗和癌症化疗成为可能。
