Tu G, Tang P, Qi Y
Department of Head and Neck Surgery, Cancer Hospital, Beijing.
Zhonghua Zhong Liu Za Zhi. 1995 Mar;17(2):118-21.
Fifty-five cases of cervical esophageal cancer treated at the Department of Head and Neck Surgery, Cancer Hospital, are reported. The three and five year survival rates were 38.2% and 35%, respectively. There are advantages for head and neck surgeons over thoracic surgeons to deal with such cases. The low recurrence rate (7.3%) of this series was a result of high resection and anastomosis at the level of the hypopharynx and hence the better safety margin of tumor clearance. The lymph node metastasis of the neck and the involvement of other neck organs were no longer contraindications of surgery as observed by thoracic surgeons. However, the head and neck surgeons have difficulties in dissecting the mediastinal lymph nodes and in preparing the abdominal viscera while the stomach or colon is to be used to restore the continuity of the upper alimentary tract. Authors concluded that since the cervical esophageal cancer is a disease in the neck, it is reasonable to be managed mainly by head and neck surgeons and otolaryngologists under the support of thoracic and abdominal surgeons and radiotherapists.
本文报告了癌症医院头颈外科治疗的55例颈段食管癌病例。三年和五年生存率分别为38.2%和35%。头颈外科医生在处理此类病例方面比胸外科医生更具优势。本系列病例复发率低(7.3%),这是由于在下咽水平进行了高切除率和吻合术,从而获得了更好的肿瘤切除安全 margins。正如胸外科医生所观察到的,颈部淋巴结转移和其他颈部器官受累不再是手术的禁忌证。然而,在使用胃或结肠恢复上消化道连续性时,头颈外科医生在纵隔淋巴结清扫和腹部脏器准备方面存在困难。作者得出结论,由于颈段食管癌是颈部疾病,在胸外科、腹部外科医生和放疗科医生的支持下,主要由头颈外科医生和耳鼻喉科医生进行管理是合理的。