tailieunhanh - Upper Gastrointestinal Surgery - part 5

Để mô tả tỷ lệ mắc ung thư thực quản trên toàn thế giới. Để phác thảo quản lý thông thường của tình trạng này. Để mô tả tiêu chuẩn phương pháp đánh giá trước phẫu thuật. Để đưa các lựa chọn điều trị trong bối cảnh. | 11 Epithelial Neoplasms of the Oesophagus Derek Alderson and Jonathan H. Vickers Aims To describe the incidence of oesophageal cancer worldwide. To outline common management of the condition. To describe standards methods of preoperative assessment. To put treatment options in context. Introduction Both benign and malignant epithelial tumours occur in the human oesophagus. The former however are all extremely rare. True papillomas adenomas and hyperplastic polyps do occur but the majority of benign tumours are not epithelial in origin and arise from other layers of the oesophageal wall. They are collectively referred to as gastrointestinal stromal tumours GIST and while the majority are truly benign malignant counterparts are well described. Most benign oesophageal tumours are small and asymptomatic and the most important point in their management is usually to carry out an adequate number of biopsies to prove beyond reasonable doubt that the lesion is not malignant. The remainder of this chapter will focus on primary malignant epithelial oesophageal neoplasms. Although again well described in many case reports the oesophagus is an unusual site for the occurrence of secondary carcinomas with the exception of bronchogenic carcinoma involving the oesophagus by direct invasion of the primary and or contiguous lymph nodes. Oesophageal Cancer Oesophageal carcinoma is an aggressive tumour which is difficult to cure. Worldwide it is the sixth most common cancer although there is wide geographical variation. Its incidence in the Western world is relatively modest United Kingdom male female per 100 000 population 1 although there is reliable evidence that this has been rising steadily in recent years due to a dramatic rise in the incidence of adenocarcinomas which now account for 75 of cases. It is the ninth highest cause of death due to malignant disease in males in the United Kingdom 1 and has an overall 5-year survival from the time of diagnosis of only 5-10 . .