胸段食管癌颈部上纵隔淋巴转移的研究

Cervical and Uppermediastinal Lymphatic Metastases of Thoracic Esophageal Cancer

探讨胸部食管癌（Ｅｃａ）颈、上纵隔ＬＮＭ规律。１９９１年１月至１９９４年１２月对２３０例胸部Ｅｃａ采取三切口行双颈、胸、腹三野淋巴结清除术。２３０例Ｅｃａ中ＬＮＭ１３８例，ＬＮＭ率６０％，共清除５７５１个ＬＮ，平均每例清除２５个ＬＮ，颈上纵隔共清除２０６４个ＬＮ，平均每例清除９个ＬＮ，胸上、中、下段Ｅｃａ颈部、上纵隔ＬＮＭ率分别为３５．２％和３８．８％、２６．７％和２１．２％、１３．３％和１６．６％。颈部、上纵隔系胸段Ｅｃａ的区域ＬＮ，Ｅｃａ根治术应该进行清除。双侧喉返神经旁ＬＮ清扫是颈。

To study the metastatic patterns to cervical and uppermediastinal lymph nodes in thoracic esophageal cancer(TEC), 230 cases of TEC were treated with subtotal esophagectomy and radical resection of cervical, thioracic and abdominal lymph nodes from January 1991 to December 1994. Of this series, 138 cases had lymph node involement with a metastatic rate of 60%. A total of 2064 lymph nodes were excised. Averaged 25 lymph nodes were removed in each case. From neck and upper mediastinum, 2064 lymph nodes were resected with an average of 9 lymph nodes in each case. The lymph node metastatic rates of neck and upper mediastinum in upper, mid and lower segment esophageal cancers were 35.2% and 38.8%, 26.7% and 21.2%, 13.3% and 16.6% respectively. The regional lymph nodes in the field of neck and upper mediastinum in TEC should be radically removed. The crucial point of this procedure is thorough excision of pararecurrent laryngeal nerve lymph nodes. 