Hildebrandt J, Nürnberger H, Lehner J, Löhlein D
Chirurgische Klinik, Städtischen Kliniken Dortmund.
Med Klin (Munich). 1994 Sep 15;89(9):459-63.
A prospective study was undertaken in 230 patients with carcinoma of the esophagus and of the cardia with infiltration of the distal oesophageal part from 1988 to 1993.
According to postoperative UICC-classification 3% of patients had stage 0, 43% stage I/II and 54% stage III/IV. 162/230 were resected (resection rate 70.4%). 55% (89/162) of resected patients had thoracoabdominocervical, 38% (62) thoracoabdominal and 8% (11) transhiatal esophagectomy. Rate of anastomotic break-down was 1.9% (3/162). Clinical mortality decreased from 32% in 1988/89 to 11% in 1990/91 to at least 0% in 1992/93 (total 13%).
Control of the postoperative phase is of decisive importance in decreasing mortality after esophageal resection, while surgical-technical problems seem to be solved. Esophagectomy is possible even as palliative measure in the presence of low mortality.
1988年至1993年，对230例食管及贲门癌伴食管远端浸润的患者进行了一项前瞻性研究。
根据术后UICC分类，3%的患者为0期，43%为I/II期，54%为III/IV期。230例中有162例接受了切除（切除率70.4%）。接受切除的患者中，55%（89/162）行胸腹颈段食管切除术，38%（62例）行胸腹段食管切除术，8%（11例）行经裂孔食管切除术。吻合口破裂率为1.9%（3/162）。临床死亡率从1988/89年的32%降至1990/91年的11%，至1992/93年至少降至0%（总计13%）。
术后阶段的控制对降低食管切除术后的死亡率至关重要，而手术技术问题似乎已得到解决。即使作为姑息性措施，在低死亡率的情况下也可行食管切除术。
