Launois B, Khelif D, Meunier B, Bardaxoglou E, Charetoń B, Landen S, Campion J P
Centre de Chirurgie digestive et Unité de Transplantation, Hôpital Pontchaillou, CHU de Rennes.
Chirurgie. 1994;120(1):40-6; discussion 47.
From 1983 to 1989, 96 oesophagectomies (30% of all oesophagectomies performed during this period) were performed without thoracotomy and then analyzed retrospectively. Most were performed due to contraindications including age (17%), respiratory disease (47%), heart disease (37%) or for superficial oesophageal lesions (35% were stage T1). Operative mortality was 3.1%. Fistulization of the anastomosis occurred in 7.5% of the cases. Actuarial survival rate at 5 years was 29% and was independent of age but dependent on localization, the size of the tumour, presence of parietal invasion and TNM classification. However, patient selection introduced bias and a prospective randomized study comparing oesophagectomy without thoracotomy and oesophagectomy via right thoracotomy and midline incision demonstrated that mortality and complications were similar with the two techniques. Long term survival was not dependent on access route, but on the stage of the disease.
1983年至1989年期间，96例食管切除术（占同期所有食管切除术的30%）在未开胸的情况下进行，随后进行回顾性分析。大多数手术是由于存在禁忌症，包括年龄（17%）、呼吸系统疾病（47%）、心脏病（37%）或因浅表性食管病变（35%为T1期）。手术死亡率为3.1%。吻合口瘘发生率为7.5%。5年实际生存率为29%，与年龄无关，但取决于肿瘤位置、大小、是否存在壁层侵犯以及TNM分类。然而，患者选择存在偏差，一项比较非开胸食管切除术与经右胸和正中切口食管切除术的前瞻性随机研究表明，两种技术的死亡率和并发症相似。长期生存不取决于手术入路，而是取决于疾病分期。
