Schröder H, Trebing G, Trebing D
Klinik für Chirurgie, Friedrich-Schiller-Universität Jena.
Zentralbl Chir. 1997;122(3):165-9; discussion 170.
54 patients suffering from esophageal cancer have been treated in a period from 1990 to 1994. In 29 cases curative resection was possible, corresponding to a resection rate of 54%. Average age of resected patients was 62 years. According to pTNM-classification the stages T1 and T2 amounted to 45%, T3 and T4 to 55%. Lymphatic node metastases were discovered with an incidence of 55%. In patients treated conservatively more unfavourable stage distributions and increased rates of lymphatic node metastasis were shown. Transthoracal-transabdominal esophageal resection was preferred as curative management. Lethality amounted to 13.8%. In 3 of 4 lethal cases after resection autopsy confirmed absence of tumor. Lethal complications were two respiratory insufficiencies, one suture line dehiscence and one alcoholic delirium. Survival rates were calculated by life-table-method. We consider the transthoracal-transabdominal esophageal resection as an acceptable therapeutic option in esophageal cancer offering a real chance of enduring curing.
1990年至1994年期间，对54例食管癌患者进行了治疗。其中29例可行根治性切除，切除率为54%。接受切除患者的平均年龄为62岁。根据pTNM分期，T1和T2期占45%，T3和T4期占55%。发现淋巴结转移的发生率为55%。接受保守治疗的患者显示出更不利的分期分布和更高的淋巴结转移率。经胸-经腹食管切除术是首选的根治性治疗方法。死亡率为13.8%。4例切除术后死亡病例中有3例尸检证实无肿瘤。致死性并发症为2例呼吸功能不全、1例缝线裂开和1例酒精性谵妄。生存率采用寿命表法计算。我们认为经胸-经腹食管切除术是食管癌可接受的治疗选择，提供了真正持久治愈的机会。
