双原发食管癌肺癌同期手术切除的疗效及安全性分析  

Surgical safety analysis of simultaneous resection for synchronous primary esophageal carcinoma and lung cancer

作　　者：蒋家好 卢春来[1] 袁云锋[1] 古杰[1] 胥丰恺 葛棣[1] 

机构地区：[1]复旦大学附属中山医院胸外科,上海200032

出　　处：《中国临床医学》2017年第2期269-271,共3页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金(81502502);上海市青年科技英才扬帆计划(15YF1402200)~~

摘　　要：目的:探讨同期手术切除双原发食管癌肺癌的临床疗效及安全性。方法:7例经病理确诊的双原发食管癌肺癌患者均行同期食管癌、肺癌根治术,观察临床疗效及手术安全性。结果:7例患者中男性6例,女性1例,平均年龄(61±7.26)岁。术前平均FEV1为(2.50±0.63)L,平均FEV1/FVC为(84.18±18.74)%,平均LVEF为(64.83±4.02)%。7例患者均顺利完成同期食管癌根治术和肺切除术,其中经上腹、右胸两切口手术5例,经左胸一切口手术2例,手术切口选择由肺部肿瘤所在部位决定,术中平均出血量(157.14±53.45)mL。7例患者术后均恢复良好,无气管-食管瘘、支气管胸膜瘘等手术相关严重并发症及死亡病例,平均术后住院时间为(11.70±1.98)d。结论:同期手术切除并不增加双原发食管癌肺癌患者的手术相关并发症,是此类患者较为安全的治疗方式,术前良好的心肺功能可能是影响手术安全性的关键因素。Objective： To investigate the safety of simultaneous resection of patients suffering with synchronous primary esophageal carcinoma and primary lung cancer. Methods： Seven patients meeting the following diagnostic criteria： histologically. All patients underwent radical resection of esophageal carcinoma, and simultaneously underwent radical resection of lung cancer. Surgical effect and sufety were observed. Results ： There were 6 male patients and 1 female patient in all the 7 patients. The mean age was （61 ±7. 26） years old. The average preoperative FEVi wa s （2. 50 ± 0. 63） L,the average FEVi / FVC was （84. 18 ± 18. 74） %, and the mean LVEF was （64. 83 ±4. 02） %. All of the 7 patients successfully underwent radical resection for esophageal carcinoma and pneumonectomy. The upper abdomen and right thoracotomy incision was performed in 5 cases,and the left thoracic incision in 2 cases. The site of surgical incision was determined by the location of lung tumor. The average intraoperative blood loss was （157. 14 ± 53. 45） mL. All the patients recovered well after operation There were no serious or deadly operative complications such as tracheoesophageal fistula and bronchopleural fistula. The average postoperative hospital stay was （11. 7± 1. 98） days. Conclusions： Simultaneous surgical resection does not increase the surgical complications and is a safe treatment of patients with synchronous primary esophageal carcinoma and lung cancer. Good preoperative cardiopulmonary function may be a key factor affecting the safety of surgery.

关 键 词：双原发癌 同期手术 安全性 

分 类 号：R735.1[医药卫生—肿瘤]