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目的:探讨食管癌伴锁骨上淋巴结转移患者的外科治疗效果。方法:作者自1991年7月～1997年6月选择性外科治疗食管癌伴锁骨上淋巴结转移患者14例并进行分析,其中男10例,女4例,年龄40～60岁。食管上段癌3例,中段癌5例,下段癌4例,食管贲门癌1例,食管胃同期原发癌1例;病变长度1.0～15cm;锁骨上淋巴结全部经针吸细胞学检查证实为转移性鳞癌13例,腺癌1例。行食管癌切除、食管胃左颈部吻合,胸内区域性淋巴结清扫12例,食管胃主动脉弓下吻合1例,单纯探查1例。结果:手术切除率92.8％(13/14),无手术死亡;随访3～54个月,平均生存时间14.6个月。结论:食管癌伴锁骨上淋巴结转移的患者选择性外科治疗并放、化疗,生物治疗,中医中药等综合治疗措施,可以改善生活质量,延长生存时间。
Objective: To investigate the surgical treatment of patients with esophageal cancer with supraclavicular lymph node metastasis. METHODS: From July 1991 to June 1997, the authors performed elective surgical treatment of 14 patients with esophageal cancer with supraclavicular lymph node metastasis and analyzed them, including 10 males and 4 females, aged 40 to 60 years. There were 3 cases of upper esophageal carcinoma, 5 cases of middle carcinoma, 4 cases of lower carcinoma, 1 case of esophageal and cardiac cancer, 1 case of primary carcinoma of esophagus and stomach. The length of lesion was 1.0 to 15 cm. All supraclavicular lymph nodes were confirmed by needle cytology. Squamous cell carcinoma in 13 cases, adenocarcinoma in 1 case. Esophageal cancer resection, esophagogastric left and neck anastomosis, intrathoracic regional lymph node dissection in 12 cases, esophagogastric aortic arch anastomosis in 1 case, and simple exploration in 1 case. Results: The surgical resection rate was 92.8% (13/14). There was no operative death. The follow-up period was 3 to 54 months and the average survival time was 14.6 months. Conclusion: Selective surgical treatment of patients with esophageal cancer associated with supraclavicular lymph node metastasis, radiotherapy, chemotherapy, biological therapy, traditional Chinese medicine and other comprehensive treatment measures can improve the quality of life and prolong survival time.