食管平滑肌肉瘤的外科治疗(附11例临床分析)

目的　探讨食管平滑肌肉瘤的临床生物学特征、诊断方法、手术方式及其预后。方法　总结分析11 例食管平滑肌肉瘤的诊断及手术治疗经验。结果　本组11 例手术切除率为100 % ,5 年生存率为54-5 % (6/11) 。诊断主要依靠食管造影、拉网及纤维食管镜(FOE) 。临床分为息肉型和侵袭型,本组息肉型4 例,侵袭型7 例,5 年生存率分别为3 例/4 例和3 例/7 例。远期肿瘤死于局部复发2 例,血行转移2 例。结论　食管平滑肌肉瘤的预后优于食管癌,息肉型预后优于浸润型。远期肿瘤死因为局部复发及血行转移。本病手术切除率高,宜采取手术治疗。

Surgical treatment of esophageal leiomyosarcoma: a review of the literature and report of 11 cases

Objective To discuss the clinical biocharacteristics, diagnosis, operation and prognosis of esophageal leiomyosarcoma (ELS). Methods Clinical materials and follow up results of 11 surgically treated ELS patients were analyzed. Results All 11 cases received radical resection of tumor. The 5 year survival rate was 54.5% (6/11). Grossly, two types of ELS were observed: the polyp form (4 cases) and invasive form (7 cases). The 5 year survival rate was 75.0% and 42.9%, respectively. Two patients died of local recurrence, another 2 cases died of distant metastasis. Conclusion In patients with ELS surgically treated, prognosis of polyp form ELS is better than that of invasive form ELS. Local recurrence and distant metastasis are the major cause of death.