【摘要】 目的探讨食管癌手术无法切除的原因。方法回顾性分析我院1985~2003年216例行开胸探查而未能切除食管癌患者及2024例行根治性切除患者的临床资料,并与我院1954~1984年食管癌未切除手术248例和770例根治切除病例相比较。结果1985~2003年资料显示,食管癌开胸探查率为9.6%(216/2240);食管癌肿瘤外侵部位最常见者依次为主动脉、肺门、气管膜部、支气管、下肺静脉、椎体及心包等;主动脉受累率为42.6%(92/216),气管、支气管受累率为25.0%(54/216),远处转移率为21.8%(47/216)。1954~1984年资料显示,食管癌开胸探查率为32.2%(248/770),主动脉受累率为35.5%(88/248),气管、支气管受累率为26.6%(66/248),远处转移率为19.8%(49/248);与1985~2003年比较,开胸探查率差异有统计学意义(P<0.05),探查原因差异无统计学意义,P>0.05。结论食管癌切除的可能性与病程、症状、病变长度、肿瘤部位、分期和大体病理类型有密切关系。由于先进诊断设备的应用,食管癌开胸探查率较以前明显下降,肿瘤外侵和转移仍然是影响手术切除的重要原因。综合各项检查,正确评估切除可能性,可降低开胸探查率。更多还原

【Abstract】 OBJECTIVE:To investigate the cause of unresected esophageal carcinoma. METHODS: Analysed the Clinical pathologic features of 216 patients on pure exploratory operation and those of 2024 patients on curetive resection, compared with those of the unresected patients and curetive resection patients of 1954-1983. RESULTS: From 1985 to 2003 the rate of pure exploratory operation were 9.6%(216/2 240); the part of the tumor invasing may be aorta, trachea, bronchi, inferior pulmonary vein, verbebra and pericardia. The rate of aorta invasion is 42.6%(92/216); that of trachea is 25%(54/216), and metastasis is 21.8%(47/216), Form 1954 to 1984, the rate of pure exploratory operation were 32.2%(248/770); the part of the tumor invasing may be aorta, trachea, bronchi, inferior pulmonary vein, verbebra and pericardia. The rate of aorta invasion is 35.5%(88/248); that of trachea is 26.6%(66/248), and metastasis is 19.8%(49/248). Compared with that from 1985 to 2003, there was significant difference in pure exploratory, P< 0.05. There was no significant difference in reason of exploratong, P>0.05. CONCLUSIONS: The esophageal carcinoma resectability is significantly relied with history, syptom, length of tumor, tumor location TNM stage and pathological classification. Blind exploration on thoracic esophageal carcinoma should be avoided.更多还原