摘要
从１９６５年４月至１９９０年１２月我们对９１０７例食管癌和贲门癌病人行外科治疗，其中食管癌６４２８例，贲门癌２６７９例。现重点对比分析２５年间前１４年（１９６５～１９７９，Ａ组）和后１１年（１９７９～１９９０年，Ｂ组）的资料，以评价外科治疗的进展。总切除率为９０．１％，食管癌和贲门癌分别为９３．２％和８２．７％。总的５年生存率为３１．６％，食管癌和贲门癌分别为４０．３％和２０．９％。Ⅲ、Ⅳ期病例，Ａ、Ｂ组分别占５８．８％和８０．４％，说明较晚期病例的外科治疗近年大为增加。因近年来进行大范围普查之故，早期病例Ｂ组比Ａ组明显减少。手术死亡率近年明显下降，Ａ、Ｂ组分别为４．４％和１．６％。为提高切除率近年术前放疗者增加，Ａ、Ｂ组为１３．２％和１８．７％。高位食管癌手术治疗者８组（６．５％）比Ａ组（３．５％）约多１倍。病变长度＞７ｃｍ而行手术者Ｂ、Ａ组分别为２４．８％和３．３％。食管颈部吻合术Ａ、Ｂ组分别为７．２％和２９．９％。６０岁以上高龄手术者Ｂ组（１９．８％）较Ａ组（８．８％）高。术后吻合口瘘两组的发生率无明显差别，但治愈率Ｂ组明显提高，为８２．２％对５５．１％。本组资料说明，由于近年围术期处理及手术技术的提?
From 1965 to 1990, a total of 9107 cases, 6428 esophageal carcinoma and 2679 gastric cardial carcinoma were surgically treated.Patients were divided into two groups according to the time peroid their surgery was performed.Group A(3155 cases)for an earlier period of 14 years(1965 to 1979)and group B(5952 cases)for a later period of 11 years(1979 to 1990).Both groups were analysed in order to evaluate advances in surgical treatments during the past 25 years.The overall resectability was 90.1%.The 5-years survival rate was 31.6%.In group A stage Ⅲand Ⅳ patients made up 55.8% and in group B 80.4%.This shows that more later stage patients were treated surgically.The operative mortality in group A and B was 4.4% and 1.6% respectively.13.2% of the cases received preoperative radiotherapy in group A,and 18.7% in group B. Cases receiving combined treatment incrcased. In group A and B, cancer in upper segment of the esophagus occurred in 3.5%and 6.5%.A lesion length of more than 7cm was found in 3.3% of group A and 24.8% of group B.In group A 8.8% of patients were over 60 and 19.8%in group B. The cervical esophagogastrostomy was 7.2% in group A and 29.9% in group B. The cure rate of anastomotic leakage was 55.1% and 82.2% in group A and B, showing an obvious improvement.The data show that marked advance in surgical treatment of esophageal and gastric cardial carcinoma has been made in recent years.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1994年第1期41-43,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
贲门癌
食管肿瘤
外科手术
Esophageal carcinoma
Gastric cardial carcinoma
Advance in surgical treatment
