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患者男,70岁,因吞咽困难6月余加剧20余天于1990年9月17日入院。体检:血压22/13kPa,双侧锁骨上淋巴结不大。钡餐:食管下段充盈缺损,长约6.5cm,僵硬,钡剂通过缓慢,食管上段轻微扩张。食管拉网找到鳞癌细胞。诊断:食管中、下段鳞癌。术中发现食管下1/3段有一长约6.0cm,直径为40cm 的肿块,质硬,肿瘤明显外侵与纵隔胸膜粘连,与主动脉无粘连。施行全食管切除,食管、胃左颈部吻合术。术后恢复良好出院。术后病理检查:肿块切面灰白,质硬,已穿透肌层到达外膜层,管壁1/3周
The patient male, 70 years old, was hospitalized on September 17, 1990 for more than 20 days due to dysphagia over 6 months. Physical examination: Blood pressure 22/13kPa, bilateral supraclavicular lymph nodes are not large. Barium meal: filling defects in the lower esophagus, about 6.5cm long, stiff, slow passage of elixir, slight expansion of the upper esophagus. Esophageal pull nets to find squamous cell carcinoma. Diagnosis: Squamous cell carcinoma of the middle and lower esophagus. During the operation, the lower 1/3 of the esophagus was found to have a length of about 6.0 cm and a diameter of 40 cm. The mass was hard, and the tumor apparently invaded the mediastinal pleura and had no adhesion with the aorta. Total esophageal resection, esophageal, and left gastric neck anastomosis were performed. Postoperative recovery was good. Postoperative pathological examination: The mass was gray in appearance, hard, penetrated into the muscular layer and reached the adventitia, and the wall was 1/3 week old.