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目的 探讨胸段食管癌根治性手术切除的长度和广度。方法 对1992年3月～1996年1月食管癌全胸段食管切除标本连续切片结果及淋巴结转移情况进行研究。结果 癌灶黏膜下浸润食管长度在3.3 cm以下;黏膜多灶癌相距最长长度7.4 cm;黏膜下癌栓可扩散2.48 cm。4％的病例食管肿瘤上缘5 cm以上的食管壁有多灶癌,食管中段癌淋巴结转移特点为上下双向转移;食管下段癌主要沿食管壁下行转移至腹腔淋巴结,4％的病例有颈部及上纵隔淋巴结转移。结论 建议胸内各段食管癌均作全胸段食管切除及纵隔和腹腔淋巴结清扫,有利于癌瘤彻底切除。
Objective To investigate the length and breadth of radical surgical resection of thoracic esophageal cancer. Methods The serial sections of the total thoracic esophagectomy specimens from March 1992 to January 1996 and the lymph node metastasis were studied. Results The submucosal infiltrating esophageal length was less than 3.3 cm. The mucosal multifocal carcinoma was the longest distance 7.4 cm. The submucosal tumor thrombus was 2.48 cm. In 4% of esophageal cancer cases, esophageal wall more than 5 cm in the upper edge of the esophageal cancer has multifocal carcinoma. The metastatic characteristics of the middle esophageal cancer is bi-directional metastasis. The lower esophageal cancer mainly translocates to the abdominal lymph node along the esophageal wall, and 4% Neck and upper mediastinal lymph node metastasis. Conclusions It is suggested that all thoracic esophageal esophageal resections should be performed with thoracic esophageal resection and dissection of mediastinal and abdominal lymph nodes, which is helpful for the complete resection of cancer.