摘要
目的探讨食管癌、贲门癌手术后复发再手术的可能性及其适应证。方法作者总结了1979年至1996年的44例食管癌、贲门癌术后复发患者进行再次手术的经验。男36例,女8例,年龄42~68岁。食管癌术后21例,贲门癌术后23例。手术切除34例,探查10例。术后发生各类并发症7例次,发生率20.5%,手术死亡2例,手术病死率5.8%。病理证实吻合口复发26例,残留食管再发癌7例,癌残留食管床复发1例。淋巴结转移15例,转移率44.1%。结果术后生存5年以上4例,3年以上4例,2年以上3例,1年以上6例,15例分别在1年及1年内死亡;探查者10例分别于6~13个月内死亡。结论对食管癌、贲门癌术后复发者,若病变未浸及动脉或气管,放疗后病变缩小,无远处转移,且心肺功能可以耐受手术者,都应积极再次手术。
Objective To review the experience of reoperation for recurrent carcinoma of the esophagus and cardia. Method Between 1979 and 1996, 44 patients with recurrent esophageal and cardiac cancer after the first operation underwent reoperation. Among them, 21 had esophageal cancer and 23 cardiac cancer. 36 patients were male and 8 female,with age ranged from 42 to 68 years. Result The resectability rate was 77 2 % (34/44) and the hospital mortality rate was 5 8 %. Postoperative complications occurred in 7 patients with a morbidity of 20 5 %. Pathologically, previous anastomotic relapse was seen in 26 patients,recurrent lesion of residual esophagus in 7,and recurrent cancerous residue at the esophageal bed in 1. 15 patients (44 %) showed lymph node metastasis. Follow up showed that 4 patients survived for 5 years, 4 for 3 years, and 3 for 2 years. 15 patients died within one year after reoperation. Conclusion The recurrence of esophageal and cardiac cancer after first operation is not a contraindication to reoperation,but careful preoperative assessment and patients′ selection should become an integral part of the evaluation of these patients.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第4期218-220,共3页
Chinese Journal of Surgery
关键词
食管肿瘤
复发
再手术
贲门癌
Esophageal neoplasm Recurrence Reoperation