胸腔镜肺部分切除术治疗肺转移癌的疗效(附45例分析)  

The long-survival of video-assisted thoracic surgery in the treatment of pulmonary metastases

作　　者：杨健[1] 姜格宁[1] 高文[1] 童稳圃[1] 朱余明[1] 汪浩[1] 谢博雄[1] 

机构地区：[1]上海同济大学附属上海市肺科医院胸外科,200433

出　　处：《临床肺科杂志》2008年第5期593-595,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的1997年6月～2004年12月，本院共进行了各类胸腔镜手术732例，对45例肺转移癌施行了肺部分切除术，占同期手术量的6．15％，男性30例，女性15例，平均年龄53．27岁。26例原发部位为肺。所有病例均行肺部分切除术。其中32例行辅助小切口。每例切除结节1～3个。有37例行孤立肺结节切除术。均为原发灶切除后2年内定期随访中发现转移。术后给予对原发肿瘤敏感的化疗4～6个疗程。结果无手术死亡，1年内失访3例。术后生存率如下：1年为75％（24／32），3年为50％（11／22），5年为45％（9／20）。死亡病例中，肺腺癌转移2例，肺腺鳞混合癌转移2例，直肠癌转移3例，类癌转移1例。术后并发症有：漏气、出血、皮下气肿、肋间神经痛。所有病员在术后1周左右出院。结论对于有条件的病人，辅以合适的全身治疗，胸腔镜肺部分切除手术治疗肺转移癌不失为一种合理的选择，创伤小，且疗效肯定。Objective To study the long-survival of video-assisted thoracic surgery in treatment of pulmonary metastases. Methotis The study included the 45 pulmonary metastases patients who were admitted in the hospital during the period of June 1997 and December 2004 and who were operated with video-assisted thoracic surgery. The characterizes of those patients were as follows ： the primary site： lung 26, colorectal tumor 5, kidney 2, breast 4, thyroid gland 1, bone 2, liver 4, lymphatic tissue 1.45 cases with VATS had wedge-resection. Results No preoperative death was reported. The long-survival of pulmonary metastases was 75 % （24/32） 1 year after the operation, 50% （ 11/22 ） after 3 years, and 45 % （9/20） after 5 years. There was no statistic difference （ P 〉 0. 05 ） between VATS and the open-thoracic wedge-resection, Conclusion In the treatment of pulmonary metastases, video-assisted thoracic surgery wedge-resection is a good choice with good long-survival rate.

关 键 词：肺转移癌 胸腔镜肺部分切除术 生存率 

分 类 号：R734.2[医药卫生—肿瘤]