Surgical Experiences in 76 Cases of Lymphatic Metastasis Recurrence with Postesophagectomy

Objective To explore the early diagnosis,reoperation and the clinical effect of the cervical lymphatic metastatic recurrence in the esophagectomy. Methods Seventy-six cases with lymphatic metastasis recurrence were retrospectively analyzed in the post 15 years in our chest surgery.They were monitored by the cervical ultrasound and were diagnosed in time.All the patients with esophagectomy were reoperated by modified neck dissection.The perioperative situation and living conditions of these patients were observed. Results All the 76 cases were tolerably able to the modified neck dissection.The perioperative death didn't occur and the life quality were good.The postoperative pathologic outcome showed that the cervical lymph nodes metastatic recurrence in the postseophagectomy were mostly in the Ⅵ,Ⅴ and Ⅳ areas.But there were no specific transfer regularity.The postoperative complications were observed in 17.1% of respiratory infection.14.5% of recurrent laryngeal nerve damage,and 3.9% of chylous fistula.After the reoperation,1-,3- and 5-year survival rates was 76.3%(58/76),35.5%(27/76),27.6%(21/76),respectively. Conclusion The timely follow up to the patients with postesophagectomy is very necessary.The neck ultrasound examination and fine-needle biopsy play an important roles in discovering the cervical lymph nodes metastatic recurrence.Taking reoperation can obtain better clinical effect.The living quality could be improved and the survival term could be prolonged for the only cervical lymphatic metastatic recurrence with postesophagectomy.There is superior to the general radiotherapy.Reoperation is one of the main choices for the patients in cervical lymphatic relapse with postesophagectomy which is valuable to be recommended in clinic.