Lymphadenectomy for Esophageal Carcinoma at the Cervicothoracic Junction. Rational Lymph Node Dissection for Esophageal Carcinoma of the Cervico-thoracic Segment: Highpoints in Dissection and Reconstruction of Trachea and Recurrent Laryngeal Nerve.

概要

論文の詳細を見る
Problems in performing curative resection and immediate reconstruction for esophageal carcinoma of the cervico-thoracic segment are discussed with special reference to lymph node metastasis by analyzing 34 esophageal carcinomas of this region operated on in the past 10 years. The results of 69 mediastinal dissections and 50 nerve repairs of the recurrent laryngeal nerve (RLN) are also discussed. A modified sternotomy, which enables an optimal operative field for both the upper mediastinal dissection and reconstruction, is also presented. Metastasis to the uppermost part of the upper thoracic paraesophageal lymph nodes (No. 105) was most frequent, indicating the importance of performing a thorough dissection around the RLN, the trachea and the innominate artery. A clear tendency toward wide spreading cervical metastasis was noticed in Ce and Ce/Iu esophageal carcinoma. On the other hand, metastasis was limited to the lower cervical lymph nodes in case of Iu and Iu/Im. Furthermore, reconstruction of RLN, together with laryngeal framework surgery, was shown to be effective in laryngeal preservation.
特定非営利活動法人日本気管食道科学会の論文