局部晚期非小细胞肺癌的外科治疗  

Surgical treatment of locally advanced non-small-cell lung cancer

作　　者：李军[1] 邱阳[1] 熊刚[1] 杨康[1] 廖克龙[1] 曾会昌[1] 王明荣[1] 

机构地区：[1]第三军医大学西南医院胸心外科,重庆400038

出　　处：《重庆医学》2008年第4期357-358,360,共3页Chongqing medicine

摘　　要：目的探讨和总结局部晚期非小细胞肺癌的外科治疗的临床经验，并评价其疗效。方法1999年6月～2006年6月，手术治疗局部晚期非小细胞肺癌21例，术中行右上肺叶切除加上腔静脉部分置换3例，右全肺切除加上腔静脉置换2例，右上肺叶切除加支气管袖式切除加上腔静脉部分置换2例，右全肺切除加隆凸成形加上腔静脉置换1例，右全肺切除加隆凸成形3例，右袖形全肺切除加气管隆凸切除重建术2例，左全肺切除加胸主动脉部分切除成形3例，左全肺切除加部分左心房切除4例，左全肺切除加胸段食管切除1例。结果全组术后早期死亡1例，死亡率4．76％。并发喉返神经损伤2例，1例术后出现肺不张，并发症发生率14．28％。随访时间5～65个月，平均38．5个月，其1、3、5年生存率分别为80．6％、45．7％、23．2％。结论局部晚期非小细胞肺癌的扩大手术治疗显著地提高和延长患者的生存质量及生存时间，但其手术适应证必须严格把握。Objective To investigate and review the surgical experience of treating LANSCLC. Methods From June 1999 to June 2006,21 patients with LANSCLC underwent surgical treatment. There were 3 cases for right upper lobectomy and replacement or partial resection of superior vena cava, 2 cases for right pneumonectomy and replacement or partial resection of superior vena cava,2 cases for right upper lobectomy and bronchoplastic sleeve lobectomy and replacement or partial resection of superior vena cava, 1 cases for right pneumonectomy and tracheobronch-oplastic procedure and replacement or partial resection of superior vena ca- va,3 cases for right pneumonectomy and tracheobronchoplastic procedure,2 cases for tracheal and carinal resection and reconstruction plus right sleeve pneumonectomy,3 cases for left pneumonectomy and thoracic aorta partial resection and reconstruction,4 cases for left pneumonectomy and partial resection of the left atrium, 1 cases for left pneumonectomy and thoracic esophageal resection in lcases. Results One died early with a mortality rate of 4.76%. Three had operative complication with the incidence rate of 14. 28% ,including two laryngeal nerve injury and one pulmonary closure. The duration of follow-up was 5- 65 months （mean, 38.5 months） and the 1,3,5-year survival rates were 80.6 % ,45.7% and 23.2% respectively. Conclusion Extended resection is a good choice for patients with LANSCLC to improve survival time and life quality,but the proper surgical indication should be classified strictly.

关 键 词：局部晚期非小细胞肺癌 外科 治疗 

分 类 号：R734[医药卫生—肿瘤]