食管良性肿瘤的诊断与外科治疗.pdfVIP

医学l临床研究 2007年12月 第24卷 第12期 J Clin Res，Dec．2007，Vol 24，№12 · 论著· 食管良性肿瘤的诊断与外科治疗 吴蔚 王海东 何萍 杨康 (第三军医大学西南医院心胸外科，重庆 400038) [摘要]【目的】总结食管良性肿瘤的临床特点，探讨合理的外科治疗方法。【方法】回顾性分析经外科手 术病理证实的51例食管良性肿瘤的临床资料。【结果】术前均无明确病理诊断，均予以手术切除，全组无手术 死亡及严重手术并发症，术中7例黏膜破损，修补后均治愈，术后病理诊断为平滑肌瘤35例，囊肿8例，脂肪 瘤4例，间质瘤4例。【结论】食管良性肿瘤临床上较少见，食管钡餐、纤维食管镜结合超声胃镜检查诊断多不 困难，但因无明确病理诊断，容易误诊，不能忽视鉴别诊断。手术切除是主要治疗手段，手术指证及术式选择 应根据不同患者的具体情况而定。 [关键词] 食管肿瘤／i~断； 食管肿瘤／外科学 Diagnosis and Surgical Treatment of Esophageal Benign Tumor WU Wei． WANG Hai—dong， HE Ping，el al(Department of Cardiothoracic Surgery，Southwest Hospital of the Third Military Medical University，Chongqing 400038) [-Abstract][Objective]To review the clinical characteristics and explore the surgical treatment of the e— sophageal benign tumor．[Methods]Clinical data of 51 patients undergoing surgical resection between January 1994 and October 2006 were analyzed retrospective1y．[Results]There was no surgical death and severe com— plications．The esophageal mucosa in 7 patients was damaged during operation，which were cured by repair． After surgery， 35 leiomyoblastomas， 8 cysts and 4 stromal tumors were pathologically diagnosed． [Conclusion]Esophageal benign tumor is infrequency in clinic．It can be easily diagnosed by fluoroscopy， esophagoscopy and endoscopic u1trasonography．However the differential diagnosis cafft be ignored．The most effective therapy for the disease is surgery，of which extra mucosal excision is the best． I-Key words] esophageal neoplasms／Dl； esophageal neoplasms／SU [中图分类号] R735．1 [文献标识码] A [文章编号] 1671～7171(2007)12—2077—03 食管良性肿瘤临床上较少见，容易误诊。本院 2例与食管癌并存)，囊肿8例，脂肪瘤4例，良性间 自1994年 1月至2006年10月收治51例，均经手 质瘤4例。 术和病理证实。现就本病的诊断和治疗体会分析报 1．2 手术方法及结果 全组经左胸手术 34例，右 道如下。 胸手术 12例，颈部 5例，其中胸腔镜下7例。黏膜 外肿瘤摘除46例(7例胸腔镜下摘除)；肿瘤食管部 1 临床资料