巨大食管平滑肌瘤的外科诊疗体会

目的探讨巨大食管平滑肌瘤的外科治疗方法。方法回顾性分析我科1995年3月-2005年3月间64例食管平滑肌瘤患者的临床资料，其中8例确诊为巨大食管平滑肌瘤，纵径10—16cm，横径5—9cm；男6例，女2例；年龄23—60岁之间；病程5～10年。根据病史、食管造影和cT扫描确定诊断，其中2例行食管黏膜外剥除以带蒂补片修补食管，6例切除肿瘤及部分食管，以胃代食管。结果术后病理证实为食管平滑肌瘤，其中3例术中冰冻报告瘤组织中可见微小肉瘤病灶，8例均获痊愈，随诊5个月-9年，无肿瘤复发。结论巨大食管平滑肌瘤-经确诊应积极手术切除肿瘤及部分食管。以胃代食管重建。疗效满意。

The experience of giant leiomyoma of the esophagus in diagnosis and surgical treatment

Objective To study diagnosis and surgical treatment of giant leiomyoma of the esophagus. Methods To review the experience of 64 cases of esophageal leiomyoma resected from March 1995 to March 2005 in our department. These included 8 giant leiomyoma and the long between 10 - 16cm,the wide 5 - 9cm. There are 6 male and 2 female patients, aged between 23 and 60 years. Their courses were 5 - 10 years. The diagnosis was established according to clinical symptoms esophagognam esophagaslogy and CT scan among the 8 giant leiomyoms two tumor was mended without damage to esophageal mucosa six underwent resection of tumor and distal esophagus with the stomach as substitue of the esophagus. Results Esophageal leiomyoma was demonstrated histopathologically in the 8 patients. But tity sarcoma lesion in tumors was demonstrated in three patients. No recurrence of tumor was found after follow - up for five months to nine years. Conclusion Resection of giant leiomyoma and partial esophagus is the choice for majority of patients with giant leiomyoma of the esophagus.