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对原发性食管小细胞癌 (PESC)的临床病理学特点及外科治疗问题进行研究。方法 1991年 4月至 1999年 4月对 2 4例PESC进行手术治疗 ,总结分析病理、临床资料。结果 全组手术切除率 91.7% (2 2 /2 4) ,手术死亡率 4.2 % (1/2 4) ,随访 2 3例术后1、2、3年生存率分别为 38 1% (8/2 1) ,2 6 3 % (5 /19) ,13 .3 % (2 /15 )。结论 PESC临床具有极高的恶性生物学行为 ,强调术前纤维胃镜活体组织病检争取确诊。手术适应证宜掌握在临床Ⅱ期 ,采用颈部重建吻合口术式 ,有利于彻底切除肿瘤及转移淋巴结 ,提高手术疗效。术后综合治疗采用放疗加化疗 ,效果较好。
To study the clinicopathological characteristics and surgical treatment of primary esophageal small cell carcinoma (PESC). Methods From April 1991 to April 1999, 24 cases of PESC were treated by surgery, and the pathological and clinical data were summarized. Results The overall resection rate was 91.7% (2/2 / 24) and the operative mortality rate was 4.2% (1/2 4). The 1, 2 and 3-year survival rates of 23 patients were 38.1% (8 / 2 1), 2 6 3% (5/19), 13.3% (2/15). Conclusions PESC has extremely high malignant biological behavior and emphasizes the diagnosis of preoperative fibrous endoscopy. Surgical indications should be held in clinical stage Ⅱ, the use of neck reconstruction anastomosis, is conducive to the complete removal of the tumor and lymph node metastasis, improve surgical outcomes. Postoperative comprehensive treatment with radiotherapy plus chemotherapy, the effect is better.