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首页> 外文期刊>Surgical Endoscopy >Laparoscopic esophagectomy in the palliative treatment of advanced esophageal cancer after radiochemotherapy.
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Laparoscopic esophagectomy in the palliative treatment of advanced esophageal cancer after radiochemotherapy.

机译：腹腔镜食管切除术在放化疗后晚期食管癌的姑息治疗中。

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BACKGROUND: Esophageal cancer is associated with a poor long-term prognosis. Only a 10% 5-year survival rate is reported. This article aims to evaluate the feasibility and efficacy of laparoscopic esophagectomy for the palliative treatment of advanced esophageal cancer (T3-T4 Nx-N1) after neoadjuvant therapy. METHODS: From March 1998 to July 2002, 35 patients (mean age, 64.6 years; range, 35-72 years) affected by advanced cancer of the middle lower third of the esophagus came to the authors' observation. All received neoadjuvant radiochemotherapy. Of the 35 patients, 22 (62.9%) showed a positive response to treatment (>or=50% reduction of maximal cross-sectional area of the tumor), and surgical intervention was performed 4 weeks after the end of the therapy. The operations were accomplished through the laparoscopic approach and left lateral cervicotomy. RESULTS: The mean operative time was 160 min (range, 120-260 min). One patient (4.5%) experienced a cervical anastomotic leak. Three patients (13.6%) died in the postoperative period: one of myocardial infarction and two of acute respiratory failure. The mean postoperative hospital stay was 12.1 days (range, 9-23 days). After a mean follow-up period of 20.2 months (range, 10-40 months), 13 patients (68.4%) were alive. CONCLUSIONS: The laparoscopic approach seems to be effective for the palliative treatment of advanced esophageal cancer. Further trials will be necessary to evaluate the advantages of this technique.
机译：背景：食道癌与长期预后不良有关。据报道仅10％的5年生存率。本文旨在评估腹腔镜食管切除术在新辅助治疗后姑息治疗晚期食道癌（T3-T4 Nx-N1）的可行性和有效性。方法：从1998年3月至2002年7月，对35例（平均年龄为64.6岁;范围为35-72岁）的食管中下三分之一的晚期癌症患者进行了观察。所有患者均接受了新辅助放化疗。在35例患者中，有22例（62.9％）对治疗呈阳性反应（大于或等于50％的最大肿瘤横截面积缩小），并且在治疗结束后4周进行了手术干预。手术是通过腹腔镜方法和左侧宫颈切开术完成的。结果：平均手术时间为160分钟（范围120-260分钟）。一名患者（4.5％）经历了宫颈吻合口漏。术后死亡3例（13.6％）：1例心肌梗死和2例急性呼吸衰竭。术后平均住院时间为12.1天（9-23天）。在平均随访20.2个月（范围10-40个月）后，有13例患者（68.4％）还活着。结论：腹腔镜方法似乎对晚期食管癌的姑息治疗有效。为了评估该技术的优势，有必要进行进一步的试验。

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