气管、隆突肿瘤外科治疗的技术探讨（附46例报告）  

Surgical management of tumors in the trachea and carina： A report of 46 patients

作　　者：廖永德[1] 艾波[1] 付向宁[1] 汤应雄[1] 严华[1] 赵波[1] 陈启福[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院普胸外科,武汉430030

出　　处：《临床外科杂志》2010年第9期625-627,共3页Journal of Clinical Surgery

摘　　要：目的 总结气管、隆突肿瘤外科治疗经验,探讨其手术相关技术的合理应用.方法 回顾分析我科2001年2月至2008年10月手术治疗46例气管、隆突肿瘤的临床资料,其中恶性肿瘤29例,良性肿瘤17例;气管环形切除并对端吻合术33例,气管和隆突切除重建术12例,气管楔形切除1例,其中5例重度气管狭窄者在股动脉-股静脉部分体外循环辅助下完成麻醉和手术;43例采用多种带蒂的自体组织包埋气管吻合口.结果 气管切除长度2.0～6.5cm,平均3.2cm;无围手术期死亡,无气管吻合口瘘,临床治愈39例（84.8%）;术后随访7个月～7年,死亡5例（10.9%）,生存至今40例（87%）,其中生存5年及以上者9例（20%）.结论 外科手术是气管、隆突肿瘤的首选治疗方法 ;保障通气、合理术式和有效的吻合口包埋是手术成功和预防并发症的关键技术.Objective To accumulate the experience in surgical treatment for primary tumors arising from the trachea and carina. Methods Clinical data about 46 patients with trachea or carina tumor who were given surgical treatment from February 2001 to October 2008 were retrospectively analyzed. Resection and reconstruction of trachea was performed in 33 patients, carinal resection and recon- struction in 12 patients,and trachea wedge resection in 1 patient. Cardiopulmonary bypass was required in 5 patients for nearly complete obstruction of the trachea. Tracheal anastomostic coverage with a pedicled flap of variable autogeneic tissues was performed in 43 cases. Results Length of resected trachea ranged from 2 to 6.5 cm with an average of 3.2 cm. No patients died in the peroperative period. Anastomotic fistula, early or late, was not seen in all patients. Thirty - nine patients （84.8%）were clinically cured. Follow - up was completed in 45 （98%）patients for 7 month to 7 years. Five patients（ 10.9% ） were died and 40 patients （87%）survived ,with 9 patients living（20% ）over 5 years. Conclusion Surgical intervention is an effective treatment for trachea and carina tumors, with acceptable complications and good long - term survival in selected patients. Sufficient pulmonary ventilation, proper surgical procedure, and anastomosis reinforcement with a pedicled flap of autogeneic tissues remain the key to the success of operation and minimizing complications.

关 键 词：气管肿瘤 隆突肿瘤 手术 体外循环 吻合口包埋 

分 类 号：R734.1[医药卫生—肿瘤]