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我科自1970年1月至1982年12月,共施行中段食管癌切除手术104例,其中有21例术后生存10年以上(生存期间每年定期来院复查),本文根据门诊复查记录及手术时的病历资料,对其能够长期生存的原因进行分析,以期对提高食管癌手术的长期生存率有所参考。 1 临床资料 本组21例中,男性20例,女性1例。年龄48—55岁(平均51岁)。职业:军队干部9例,地方干部12例。21例病人入院前均有进食梗噎症状,3例祖藉在食管癌高发区且有三代遗传史。全组病人术前均经食管镜检查确诊。食管病变长度<3.0cm者6例,3.0—5.5cm15例(平均3.8cm)。食管切除后均采用胃代食管,食管与胃端侧吻合,其中主动脉弓上吻合16例,颈部吻合5例。病理检查:全部为食管中段鳞状上皮癌。食管残端切缘阴性,临床病理分期(1976年阳泉会议):0期(原位癌)4例,Ⅱ期15例,Ⅲ期2例。组织学分级:Ⅰ级10例,Ⅱ级9例,Ⅲ级2例。
In our department from January 1970 to December 1982, a total of 104 cases of middle esophageal cancer resection were performed. Among them, 21 cases survived for more than 10 years after surgery (recurring every year during the life cycle). This article was based on outpatient review records and surgery. The medical history data analyzes the reasons for its long-term survival, with a view to improving the long-term survival rate of esophageal cancer surgery. 1 Clinical data In this group of 21 cases, there were 20 males and 1 female. Age 48-55 years old (average 51 years old). Occupation: 9 military cadres and 12 local cadres. Twenty-one patients had symptoms of eating sputum before hospitalization. Three of the ancestors had a high incidence of esophageal cancer and had three generations of genetic history. All patients were confirmed by esophagoscopy before surgery. Esophageal lesion length <3.0cm in 6 cases, 3.0-5.5cm in 15 cases (average 3.8cm). Gastro-esophageal esophagus was used after esophagectomy. The esophagus and the stomach were anastomosed. There were 16 cases of aortic arch anastomosis and 5 cases of neck anastomosis. Pathological examination: All squamous cell carcinoma of the middle esophagus. The margin of esophageal stump was negative, and the clinical pathological stage (Yangquan meeting in 1976) was: 0 (in situ carcinoma) in 4 cases, stage II in 15 cases, and stage III in 2 cases. Histological grade: 10 cases in grade I, 9 in grade II, and 2 in grade III.