颈段食管癌91例外科治疗经验总结

本文报告了颈段食管癌91例外科治疗的经验，手术方式以食管内翻剥脱、全食管切除的方法最好，将胃或结肠从食管床上提到颈部。根据病变上缘的位置决定是否保留候。T3、T1病变占绝大多数，本组为81例（占89％）。以术前放疗加手术的治疗方式疗效最好，3年生存率54．3％，5年生存率51．6％，优于单纯手术及单纯放疗。本组病例术后下颈部及锁骨上复发17例，占18．6％，纵隔淋巴结转移2例，占2．2％。术前放疗皮包括颈部淋巴结，而且手术时应根据情况考虑颈部淋巴结清扫及纵隔淋巴结清扫，以提高治愈率。

Experiences of Surgical Treatment in 91 Cases with Cervical Esophageal Carcinoma

The surgical experiences on 91 cases with squamous cell carcinoma of the cervical esophagus fromJanuary, 1964 to the end of the 1994 were reported. T8 and T4 lesions were predominant in all (81/91,89%). Preop-erative planned radiotheray (40Gy-50Gy) followed by surgery achieved the best response. Three year and fiveyear survival rate were 54.3% and 51.6% respectively. It is better than that of surgery alone or radiotherapy alone.Seventeen (18.6%) cases with lower neck and supraclavicular lymph node recurrence, 2 cases (2.2%) withmediastinal lymph node metastusis were found in this series. Preoperative radiotherapy should includ cervicalnode. The lower cervical lymph node dissection and upper mediastinal lymph node dissection should be consideredaccording to the patient's condition.