部分左心房切除的全肺扩大切除术在局部晚期肺癌手术中的应用  

Application of pneumonectomy with partial resection of left atrium in local advanced lung cancer

作　　者：李秋泽[1] 杨立信[1] 姚峰[1] 徐志云[1] 

机构地区：[1]第二军医大学附属长海医院胸心外科,上海市200433

出　　处：《实用医学杂志》2009年第2期247-249,共3页The Journal of Practical Medicine

摘　　要：目的:分析部分左心房切除的全肺扩大切除术治疗局部晚期肺癌的可行性。方法:1999年7月至2008年3月,21例患者实施部分左心房切除的全肺扩大切除术治疗Ⅲ期中央型肺癌,未采用体外循环方法。结果:全组无术后死亡,平均ICU时间及住院时间分别是2d和7.9d。有3例患者术后并发心律失常,2例并发呼吸功能不全,经治疗后痊愈。平均5年生存期19.1%。结论:部分左心房切除的全肺扩大切除术治疗局部晚期肺癌是一项可行的手术方式。通过术前经PET-CT的筛查排除纵隔淋巴结转移及术中对左心房受侵犯情况的仔细探查和彻底切除可以得到较好的手术效果,起到局部控制肿瘤的作用。Objective To explore the feasibility of partial resection of left atrium for local advanced lung cancer. Methods 21 patients with stage Ⅲ central lung cancer underwent extended pneumonectomy with partial resection of left atrium without cardiopulmonary bypass from July 1999 to March 2008 were analyzed. Results None of the patients died after operation, the median times of staying in ICU and hospital were 2 days and 7.9 days, respectively. There were 3 patients with arrhythmia and 2 patients with respiratory insufficiency after operation, and were successfully cured after treatment. The 5-year probability of survival was 19.1%. Conclusions Extended pneumonectomy with partial resection of left atrium for local advanced lung cancer is a feasible procedure, which may reach better effect after preoperative PET-CT scanning to exclude mediastinal lymph node metastasis and after extensive assessment and thorough resection of atrial invasion.

关 键 词：肺肿瘤 肺切除术 左心房 

分 类 号：R734.2[医药卫生—肿瘤] R739.630.5[医药卫生—临床医学]