食管平滑肌瘤的诊断及外科处理

[目的]总结食管平滑肌瘤诊断和治疗经验.[方法]回顾分析1960～2003年北京市协和医院收治的食管平滑肌瘤79例病例资料.[结果]行开胸手术70例,其中平滑肌瘤摘除术65例,食管部分切除＋胃、食管吻合术5例;内镜下电套圈切除5例,未进一步治疗4例;手术组术后1例（1964年）出现食管胸膜瘘,切口感染2例,胸腔积液2例,均治愈出院;全组病理均证实为食管平滑肌瘤,未见平滑肌肉瘤.无死亡病例.随诊34例,2例复发,未见恶性变.[结论]食管平滑肌瘤的治疗以经胸平滑肌瘤摘除术为首选,但治疗方法的选择及手术适应征的把握仍值得进一步讨论.

DIAGNOSIS AND SURGICAL TREATMENT OF ESOPHAGEAL LEIOMYOMAS

[Objective] To summarize the diagnosis and treatment of the esophageal leiomyomas. [Methods] A retrospective survey was carried out in 79 patients of the Peking Union Medical Hospital from 1961 to 2003. [ Results] in the 70 cases of thoracotomies, enucleation of tumors were performed on 65 patients and esophagectomy were performed on 5 patients, circular resection by gastroscope was performed on 5 cases, and 4 patients were not further treated. In operation group, 1 patient was attacked with esophageal fistula, 2 cases occurred infection of incisional and 2 cases were with pleural effusion. All the cases were confirmd to be esophageal leiomyomas in pathology, rather than smooth muscle sarcom. There was no death case. In the 34 follow-up causes, two patients relapsed, but there was no malignant change. [Conclusion] Enucleation of tumors should be firstly selected for therapeusis of esophageal leiomyomas, but the selection for the therapeutic methods and operational indications need futher discussion.