72例早期食管癌的外科治疗

目的为了提高早期食管癌的确诊率和远期生存率。方法对1977年1月至1997年9月手术治疗的72例早期食管癌进行回顾性分析。结果本组X线检查的检出率为81.9％（59／72）、纤维食管镜检查的确诊率为89.1％（57／64）、食管拉网细胞学检查的确诊率为91.7％（11／12）;术后5、10、15年的生存率分别为91.2％（31／34）、66.7％（14／21）和62.5％（5／8）。结论高度重视早期食管癌的症状,选择针对性检查方法,必要时采用多项检查方法,并结合临床症状进行综合分析,可提高早期食管癌的诊断率。术后食管癌复发和转移是早期食管癌术后的主要死亡原因,因此,对早期食管癌也应按肿瘤外科的原则行食管的次全切除术。

Surgical Treatment of 72 Cases with Early Esophageal Carcinoma

Purpose To improve the rate of confirm diagnosis and the long -term survival rate of early esophageal carcinoma. Methods Seventy-two cases with early esophageal carcinoma received surgical treatment from Jan. 1977 to Sep. 1997 were analyzed retrospectively. Results The detectable rate of early esophageal carcinoma by x-ray examination was 81. 9% (59/72). The confirm diagnosis rate by esophageal fibroscopy was 89. 1 % (57/64) and the confirm diagnosis by exfoliated cytopathology examination of esophagus was 91. 7% (11/12 ). The 5-, 10-and 15-year survival rates were 91. 2 % (31/34 ), 66. 7 % (14/21 ) and 62- 5 % (5/8) respectively. Conclusions Paying attention to the symptoms of the early esophageal carcinoma,choosing proper examinations,applying multiple examinations and combining with clinical symptoms could improve the confirm diagnosis rate of the early esophageal carcinoma. Postoperative recurrence and metastasis were the main dead reasons for early esophageal carcinoma. It suggested that subtotal esophagectomy should be performed in early esophageal carcinoma according to the surgical rules of oncology.