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食管癌手术治疗的疗效,近年来已明显提高,手术死亡率已降到1～2%。过去日本的食管癌手术基本遵循中山恒明1965年创立的三期根治术法:①胃造瘘;②胸部食管切除及颈食管造瘘;③食管再建术。这种方式虽使上中段食管癌切除率达40%,手术死亡率为7.5%,但手术时间长,仅20～25%的患者能作再建手术,五年生存率仅10%。因此作者赞同对食管癌行一期根治手术。食管癌术后死亡原因主要有二:①肺合并症:
The efficacy of surgical treatment of esophageal cancer has increased significantly in recent years, and the surgical mortality rate has dropped to 1 to 2%. In the past, esophageal cancer surgery in Japan basically followed the three phases of radical mastectomy established by Zhongshan Hengming in 1965: 1 stomach fistula; 2 chest esophageal resection and neck esophageal fistula; 3 esophageal reconstructive surgery. Although this method makes the upper and middle segment of esophageal cancer resection rate of 40%, the surgical mortality rate of 7.5%, but the long operation time, only 20 to 25% of patients can be rebuilt surgery, the five-year survival rate is only 10%. Therefore, the authors approve of a radical operation for esophageal cancer. There are two main causes of postoperative death in esophageal cancer: 1 Pulmonary complications: