240例早期食管癌外科手术治疗效果分析

Analysis of surgical treatment effects for 240 cases with early esophageal carcinoma

目的：分析根治性外科手术对早期食管癌的治疗效果，探讨术后并发症与食管癌复发、转移的防治。方法回顾性分析解放军总医院2005年1月—2009年1月240例早期食管癌患者的治疗情况。患者均采用经左侧开胸，胸内或颈部机械吻合术的外科手术方法进行治疗，对其术后不良反应、并发症及1、3、5年生存率进行观察分析。结果手术切除率100．00％。术后发生肺部感染12例（5．00％），心率失常1例（0．42％），胃排空障碍2例（0．83％），胸腔内出血1例（0．42％），喉返神经损伤2例（0．83％），吻合口瘘1例（0．42％）。术后1、3、5年生存率分别为100．00％（240／240）、97．92％（235／240）、95．83％（230／240）。术后死亡的主要原因是肿瘤的复发和转移。结论早期食管癌通过及时外科手术治疗，手术效果良好，并发症较少，能够获得很好的远期疗效。

Objective To study the effects of radical surgical treatment for early esophageal cancer, and to investigate the prevention and cure of their complications,cancer recurrence and metastasis.Methods Treatments of 240 patients with early esophageal cancer of Chinese PLA General Hospital from January 2005 to January 2009 were retrospectively analyzed.The patients were treated by left thoracotomy,thoracic or cervical mechanical anastomosis surgical methods of treatment.Their postoperative adverse reactions,complications and 1 -,3-,5-year survival rates were observed and analyzed.Results The surgical resection rate was 1 00.00%. Complications included postoperative pulmonary infection （1 2 patients,5.00%）, cardiac arrhythmias （1 patient,0.42%）,delayed gastric emptying （2 patients,0.83%）,pleural hemorrhage （1 patient, 0.42%）,recurrent laryngeal nerve injury （2 patients,0.83%）and anastomotic fistula （1 patient,0.42%）. One-year,3-year and 5-year survival rates after surgery were 1 00.00% （240 /240）,97.9% （235 /240）and 95.8% （230 /240）respectively.The main causes of postoperative death were tumor recurrence and metastasis. Conclusion Timely surgery for early esophageal cancer can bring in good effect and long-term outcome,with little complication,which can obtain a good forward curative effect.