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題名 | Leiomyoma of the Esophagus--15-Year Experience=食道之平滑肌瘤--15年經驗 |
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作者姓名(中文) | 李世俊; 程永隆; 許正義; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 31:4 民87.07-08 |
頁次 | 頁239-245 |
分類號 | 416.241 |
關鍵詞 | 食道; 平滑肌瘤; Esophageal neoplasm; Leiomyoma; Diffuse leiomyomatosis; Surgery of esophagus; |
語文 | 英文(English) |
中文摘要 | 食道之平滑肌瘤是少見,但是是食腫瘤中最常見之良性腫瘤。統計1982至1997年,在本院共有7位食道之平滑肌瘤病患接受手術治療。有6位病患有臨床症狀,其中以吞嚥困難最常見(71%)。鋇劑食道攝影皆發現有填充缺陷(filling-defect)。光纖食道鏡檢發現有黏膜下腫瘤,但食道黏膜是正常。電腦斷層攝影顯示腫瘤與縱膈腔器官分界清楚。三例腫瘤位於食道中段、三例在下段、一例是瀰漫性侵犯上三分之二的食道。6位有局部腫瘤之病患,接受經胸食道腫瘤挖除術;瀰漫性食道平滑肌瘤之患者,接受食道切除及食道重建術。所有病患皆有不錯的預後。局部的食道平滑肌瘤,可實施腫瘤挖取術而得到很好的結果;而瀰漫性之食道平滑肌瘤,實施食道切除併重建術,才是治療的選擇。 |
英文摘要 | Leiomyoma of the esophagus is rare but the most common benign tumor of the esophagus. Seven patients with leiomyoma of the esophagus were treated surgically from 1982 to 1997, accounting for 0.6% (7/1171) of all esophageal neoplasm seen at our hospital. Most (6/7) of the patients were symptomatic, with dysphagia being the most common symptom (71%). Barium esophagography showed sharply demarcated filling defects in the barium-filled esophagus, often compressing the esophageal lumen while fibroesophagoscopy demonstrated the tumor, covered with intace mucosa, as a bulge in the wall of the esophagus. Computerized tomographic (CT) scans of the chest showed the relationships of the tumor and mediastinal structures with distinct planes of separation. Three tumors were located in the middle third region of the esophagus, three in the lower third, and another encircling the upper two thirds of the esophagus. All tumors were intramural. Six patients with localized lesions underwent transthoracic enucleation of the tumor. Whereas, one patient with diffuse leiomyomatosis of the esophagus received intrathoracic esophagectomy with cervical esophago-gastrostomy via the substernal route. All patients showed excellent results after the surgery. Enucleation of the focal esophageal leiomyoma were sufficient for most patients. On the other hand, if the tumor is diffuse or circumferential encircling involvement, a total resection of the esophagus is indicated. |
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