支气管隆凸血管成形术治疗肺癌96例疗效分析  

Results of Bronchial Sleeve Resection and Plasty,Carinal Resection and Reconstruction,and Angioplasty in the Treatment of Primary Lung Cancer:Report of 96 Cases

作　　者：马富锦[1] 史宁江[1] 高昕[1] 滕洪[1] 曲家骐[1] 侯维平[1] 

机构地区：[1]沈阳军区总医院胸外科

出　　处：《中华胸心血管外科杂志》1998年第2期90-92,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：为探讨支气管、隆凸和血管成形术治疗肺癌的疗效，对９６例中心型肺癌分别施行支气管、隆凸和血管成形术６４、２０和３０例次。随访１、３、５年生存率分别为７９％、５１％、４８％；接受支气管、隆凸、血管成形术的５年生存率分别为５７％、２０％、３１％。结论：支气管、隆凸、血管成形术可以扩大肺癌的手术适应证、最大限度地保存肺功能，疗效不亚于单纯肺切除术。Aim:Longterm results after bronchoplasty,angioplasty and carinal resection and reonstruction in the treatment of primary lung cancer varied at different clinics.This paper reviewed the experience of clinical application of these procedures.Clinical material and method:Ninetysix patients with lung cancer(stage 0 in 1,stage I in 32,stage II in 7,stage IIIa in 27,stage IIIb in 28 and stage IV in 1)were treated surgically from January 1987 to February 1996.There were 88 men and 8 women with a mean age of 57.4 years(range,31 to 70years).73 patients had squamous carcinoma;9,adenocarcinoma;6,small cell carcinoma;3 adenosquamous carcinoma;and 5,other types of carcinoma.Bronchial sleeve resection and plasty were performed in 64 patients,carinal resection and reconstruction in 20:carinal resection without pulmonary resection in 1,carinal plus lobar resection in 11 and carinal pneumonectomy in 8. 30 angioplasties were performed.Results:There were 3 postoperative deaths with a mortality of 3.1%.The causes of death were respiratory failure in 1 and anastomotic leak in 2.The overall 1year,2year and 5year survival rates were 79%(69/87),51%(32/63)and 48%(24/50)respectively.The 5year survival rates for bronchoplasty,carinal reconstrucion,angioplasty and double sleeve resection were 57%(21/37),20%(1/5),31%(5/16)and 25%(1/4)respectively.Conclusion:This study suggests that the use of aforementioned procedures in patients with lung cancer,particularly in advanced ones with poor lung function,may be associated with good longterm results.It can be performed with no significant increase in operative morbidity or mortality.The procedures allow sleeve resection of any lobe or the main bronchus and thus maximize preservation of functional pulmonary parenchyma.

关 键 词：肺癌 支气管成形 隆凸成形 血管成形术 

分 类 号：R734.205[医药卫生—肿瘤]