Segol P, Marchand P, Roussel A, Cazagou J F, Gignoux M
Acta Chir Belg. 1982 Jul-Aug;82(4):405-9.
Perforation of an esophageal cancer can occur spontaneously or during radiotherapy. If the perforation is the first manifestation of the cancer, the diagnosis depends on X-ray and endoscopy. During radiotherapy, the intending perforation must be carefully watched for. We have treated two perforations appearing as first manifestation of the cancer and 3 developed during evolution, 2 of them during radiotherapy. Various treatments have been applied. In 2 cases, resection was possible, curative in one, palliative in the other. In the other 3 cases, retrosternal by-pass has allowed feeding and radiotherapy. Such a complication generally condemns the patient to a gastrostomy. However, a more aggressive surgical attitude can be adopted if the general status of the patient permits. An esophageal endo-prosthesis can also be used.
食管癌穿孔可自发发生或在放疗期间出现。如果穿孔是癌症的首发表现，诊断依赖于X线和内镜检查。在放疗期间，必须密切观察有无即将发生的穿孔。我们治疗了2例穿孔为癌症首发表现的患者，以及3例在病程中发生的穿孔，其中2例发生在放疗期间。已采用了各种治疗方法。2例可行切除术，1例为根治性切除，另1例为姑息性切除。另外3例患者，胸骨后旁路术实现了营养供给并能继续放疗。这种并发症通常使患者不得不接受胃造口术。然而，如果患者的一般状况允许，可以采取更积极的手术态度。也可使用食管内置假体。
