胸段食管癌颈淋巴结廓清体会

CervicaI Lymph Node Dissection in.Carcinoma of Thoracic Esophagus

我院自１９８８年１月至１９９０年１２月间行胸段食管癌的根治性切除，两侧颈部淋巴结廓清２０例。７例颈淋巴结转移，占全组３５％。颈深淋巴结（１０２组）和锁骨上淋巴结（１０４组）转移多见，均占５５．６％。颈部淋巴结转移与肿瘤发生部位和分化程度有关，食管中上段部占８５．６％，低分化者占５５．６％。本组淋巴结跳跃转移２例。术前颈部触不到淋巴结不能除外颈淋巴结转移的存在。本组２０例中颈、胸、腹淋巴转移率分别为３５％、５５％和３０％。作者讨论了颈淋巴结廓清的范围，术中操作的要点及其术后处理。

0 cases of carcinoma of thoracic esophagus which received radical resection were reported,accountingfor l6.1%of all caseas of esophageal carcinoma during the same period of January l988 to December 1990in our department.The metastasis of bilateraly dissected cervical lymph nodes were discussed. Out of 20 cases,7 cases (35%)had cervical lymphatic metastasis.The common sites of metastasis were deep cervical(group 102)and supraclavicular lymph nodes (group 104),each accounted 55.6%respectively. It ap-peared that the location of the lesion and differenciation of the cancer were associated with the metastasis。Most metastasis (85.6%)occured in the upper or middle esophageal cancer, and 55.6%were pooly differentiated. There were 2 cases demonstrating skipping metastasis.The negtive flnding in preoporative paldationof the cervical lymph nodes did not rule out the posibility of metastasis.In the 20 cases,the metastasis rateof cervical, thoracic and abdominal lymph nodes were 35%,55%and 30%respectively。The extent andmethod of dissecting cervical lymph nodes,and postoperative treatment were discussed。