肺切除加左心房部分切除治疗局部晚期肺癌  

Pulmonary resection combined with partial resection of left artrium for treatment of locally advanced lung cancer

作　　者：匡裕康[1] 曾来铎[1] 王东升[1] 阴兵林[1] 吴九发[1] 黄建[1] 何枝生[1] 朱剑峰[1] 江峰[1] 郭昌莹[1] 

机构地区：[1]江西省肿瘤医院胸外科,南昌330029

出　　处：《江西医药》2010年第4期287-289,共3页Jiangxi Medical Journal

摘　　要：目的总结左心房部分切除技术治疗局部晚期肺癌的临床经验。方法1997年7月～2008年8月,40例肿瘤累及左心房的局部晚期肺癌在我科接受手术治疗。术中采用心耳钳钳夹左心房壁,在距肿瘤边缘0.5～1cm处切除部分左心房壁,其中5例联合切除部分食管肌层,整块切除肺肿瘤。左心房切缘用3-0无损伤线或4-0普罗纶线连续来回缝合。术前诱导化疗11例,术后化疗23例,其中1例联合放疗。结果术后心律失常3例,其中伴有心肺功能不全1例。无手术死亡,全组病例均治愈出院。术后病理:鳞癌22例,小细胞癌10例,小细胞癌伴鳞癌1例,腺癌3例,腺鳞癌3例,未分类1例。术后1、3、5年生存率分别为80.6%(29/36)、37.0%(10/27)和38.9%(7/18)。结论肺切除加左心房部分切除治疗局部晚期肺癌具有较好的临床疗效,部分病例可因此获得治愈。Objective To review the clinical result of pulmonary resection combined with partial resection of left artrium in treatment of locally advanced lung cancer involving left artrium.Methods From July,1997 to August,2008,40 patients with locally advanced lung cancer involving left artrium underwent surgical treatment.24of them were treated with pneumonectomy（16 left,8 right） combined with partial resection of left artrium,16with lobectomy or bronchial sleeve lobectomy and partial resection of left artrium.Of them,5cases combined with partial muscle resection of esophagus.11 patients recieved preoperative chemotherapy,23cases received postoperative chemotherapy,only one recieved postoperative chemotherapy combined with radiotherapy.Results Pathological diagnosis：SCLC was in 10 cases,squamous carcinoma in 22 cases,adenocarcinoma in 3 cases,adenosquamous carcinoma in 3case,SCLCand squamous carcinoma in 1 case,do not divided in 1 case.No operative death has occurred.Postoperative arrhythmia occurred in 3 cases,one of them with cardiopulmonary insufficiency.All patients were cured clinically.The postoperative servival rate of 1,3 and 5 year was 80.6%（29/36）,37.0%（10/27）and 38.9%（7/18）respectively.Conclusion Pulmonary resection combined with partial resection of left artrium in treatment of locally advanced lung cancer involving left artrium can obtain a good effectiveness.

关 键 词：肺肿瘤 肺切除 左心房部分切除 

分 类 号：R734.2[医药卫生—肿瘤]