摘要:目的:探讨晚期食管癌切除、纵隔淋巴结清扫及术中纵隔热灌注化疗对残留于气管、支气管、胸主动脉、奇静脉等器官的癌性肉眼微小病灶治疗效果。方法:选择食管癌病变浸润超过外膜层外侵至气管、支气管、胸主动脉、奇静脉等器官患者112例，随机分为两组:治疗组56例,术中42～43℃无菌蒸馏水2000～2500 mL加入顺铂(DDP)150 mg及氟尿嘧啶(5FU)1200 mg在体外循环下行纵隔热灌注化疗40 min;对照组56例,术中未进行纵隔热灌注化疗。结果:治疗组术后第一年有6例出现纵隔区域肿瘤复发及淋巴结转移,术后第二年有11例纵隔区域肿瘤复发及淋巴结转移;对照组术后第一年有14例出现纵隔区域肿瘤复发及淋巴结转移,术后第二年23例出现纵隔区域肿瘤复发及淋巴结转移。结论:晚期食管癌术中纵隔热灌注化疗可明显减少或延迟纵隔区域肿瘤复发及淋巴转移,提高术后第一至第二年生存率。Abstract: Objective: To explore the advanced esophageal cancer resection, mediastinum, lymph node dissection, mediastinum, hot infusion chemoembolization and clinical observation of residual heat infusion chemoembolization and trachea, or the thoracic aorta, bronchus, eye cancer organs such as intravenous of tiny lesions therapeutic effect. Methods: Select esophageal lesions than the outer membrane layer of infiltrating the trachea and bronchus to the thoracic aorta, and 112 cases of patients with venous organs such as random points to two groups: treatment group treated with perfusion of 56 cases at 4243 degrees Celsius sterile 2000 mL distilled water 2500 mL ~ (DDP) joined cisplatin 150 mg, 5fluorouracil (5FU 1200 mg) in extracorporeal circulation downlink mediastinal hot perfusion 40 minutes, control group treated with perfusion of 56 cases without mediastinal hot perfusion chemotherapy. Results: Treatment group in 6 cases occured after first mediastinal tumor recurrence and regional lymph node metastases after 11 cases, the regional recurrence and lymphatic metastasis mediastinal, control group first fill after 14 cases mediastinal tumor recurrence and bureau of regional lymph node metastasis appeared in 23 cases, surgery between regional tumor locally recurrent lymph node metastases. Conclusion: Advanced esophageal intraoperative mediastinal hot perfusion chemotherapy can obviously reduce or delay mediastinal tumor recurrence and regional lymph node metastases, raise the firstsurial.