摘要
目的探讨食管贲门癌手术探查不能切除的原因。方法和结果回顾性分析我院１９７２年至１９９７年９５６例食管贲门癌资料（食管癌５６０例，贲门癌３９６例），切除８０９例，总切除率８４６％。手术探查１４７例（食管癌７５例，贲门癌７２例），总探查率１５３％。贲门癌的探查率比食管癌高，病程与探查率成正比，性别与探查率无显著差异。胸骨后隐痛及异物感是最早出现的症状，而后才出现进行性吞咽困难，不能单凭癌灶长度判断能否切除。病理类型、生理年龄、免疫机能也是术前考虑的因素。结论外科切除仅对Ｔｉｓ和Ｔ１Ｔ２ＮＯ的患者才是标准治疗。应用Ｘ线、ＣＴ、ＥＵＳ、ＶＡＴＳ等诊断手段，确定食管癌、贲门癌的术前临床分期，对于是否可达到根治性切除，是至关重要的，从而提高手术切除率，减少不必要的手术探查。
Purpose Toexplorethecausesofinadvisabilityofresectionofesophagealandcardiaccarcinoma.MethodandResult:Dataof956casesofesophagealandcardiaccarcinoma(560oftheformerand396ofthelatterr)duringtheperiedof1972to1997wereanalysedretrospectively.Outofthemtherewere809casesofresection(resectionrateof846%),147casesofsurgicalexplorationwithexplorationrateof153%(including75ofesophagealcarcinomaand72ofcardiaccarcinoma).Theexplorationrateofcardiaccarcinomawashigherthanthatofesophagealcarcinoma.Courseofdiseasewasdirectlyproportionaltotheexplorationrate.Thedifferenceofsexwithexplorationratewasinsignificant.Theearliestsymptomwasdullpainandforeignbodysensebehindsternobone,thenaprogressiveswallowingdifficultyappeard.Thelengthofcarcinomashouldnotberegardedastheonlycriterionofsuitabilityforresection.Pathologicaltype,physiologicalage andimmunityfunctionshouldbeincludedintopreoperativeconsideration.Conclusion:SurgicalresectionisastandardtherapyonlyforthosepatientsofTisandT1T2NO.UtilizingdiagnosticmeanslikeXray,CT,EUS,VATS,and
出处
《福建医药杂志》
CAS
1999年第2期10-11,共2页
Fujian Medical Journal
关键词
食管贲门癌
手术探查
手术前
临床分期
EsophagealandcardiaccarcinomaSurgicalexplorationPreoperativeclinicalstageRadicalresectiondeterminingthepreoperativeclinicalstageareofhighestimportanceforachievementofradicalresection.
