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原发性食管癌向邻近食管或胃壁的壁内转移者的预后不佳。为了比较扩大根治术的效果(指全胸段食管切除和双颈,纵隔及腹淋巴结清扫术),作者在54例伴壁内转移和270例无壁内转移的食管癌病例分别采用扩大根治术和一般根治术,观察其肿瘤扩散类型和长期生存率。所谓一般根治术(稍小的根治术)适用于早期粘膜型食管癌,或病变广泛已超越治愈性切除的范畴。所谓壁内转移是指:(1)转移灶明显与原发灶分开;(2)位于食管或胃壁;(3)肉眼观为粘膜下层肿瘤而无上皮内癌扩展;(4)与原发灶相同的组织学类型;(5)无血管内癌肿生长的证据。155例施行了扩大根治术,切除胸段食管和近端侧胃(胸骨切迹上项颈切口、右胸切口和正中剖腹切口),清除颈
The prognosis of primary esophageal cancers that migrate into the wall adjacent to the esophagus or stomach wall is poor. In order to compare the effects of radical mastectomy (referring to total thoracic esophagectomy and double-neck, mediastinal, and abdominal lymphadenectomy), the authors used extended radical mastectomy in 54 cases of intramural metastasis and 270 cases of esophageal carcinoma without intramural metastases, respectively. And general radical surgery to observe the type of tumor proliferation and long-term survival. The so-called general radical surgery (slightly radical surgery) is applicable to early mucosal esophageal cancer, or the lesions have broadly surpassed the scope of curative resection. Intramural metastasis refers to: (1) the metastasis is clearly separated from the primary lesion; (2) is located at the esophagus or stomach wall; (3) the macroscopic view is submucosal tumor without expansion of the intraepithelial carcinoma; (4) with the primary lesion The same histological type; (5) Evidence of no intravascular cancer growth. Extensive radical surgery was performed in 155 patients. The thoracic esophagus and the proximal stomach were removed (the sternal notch neck incision, the right thoracic incision, and the midline laparotomy incision) and the neck was removed.