外科治疗气管及主支气管肿瘤30例  

Surgical treatment for 30 patients with tracheal and main bronchial tumors

作　　者：臧彬[1] 刘军[1] 石文君[1] 

机构地区：[1]中国医科大学附属盛京医院胸外科,沈阳110000

出　　处：《中国胸心血管外科临床杂志》2017年第8期617-621,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：卫生部科技专项中标项目(WKZ-2000-1-17)

摘　　要：目的探讨气管及主支气管肿瘤的外科治疗方法。方法回顾性分析2000年1月至2015年12月中国医科大学附属盛京医院30例气管、主支气管肿瘤患者的临床资料,其中男12例、女18例,年龄22~80岁。结果 10例行气管肿瘤核除术,12例行气管肿瘤切除+端端吻合术,1例行气管肿瘤窗形切除术,1例行气管肿瘤楔形切除术,5例行气管肿瘤切除+利用肺组织瓣行气管重建术,1例行左全肺切除术。1例患者于术后26 d突发大咯血死亡,2例患者出现围术期并发症,其余患者均恢复良好。随访11个月至14年,8例患者术后随访未满5年,1例术后14个月突发大咯血死亡,其余健在;21例患者随访超过5年,其中失访5例。结论气管、主支气管肿瘤首选外科治疗,良性病变且长度较小,可考虑行气管肿瘤局部切除,气管节段切除+端端吻合术是经常采用的手术方式,气管病变超过全长的1/2或存在吻合口缺血坏死风险的病例可选择气管重建。Objective To study the surgical treatment of tracheal and main bronchial tumors.Methods We retrospectively analyzed the clinical data of 30 patients with tracheal and main bronchial tumors treated in Shengjing Hospital of China Medical University from January 2000 to December 2015. There were 12 males and 18 females with the age ranging from 22 to 80 years.Results Ten patients were treated with enucleation, 12 patients tracheal tumor resection and end-to-end anastomosis, 1 patient window resection, 1 patient wedge resection, 5 patients tumor resection and tracheal reconstruction by using pulmonary tissue flap with alloy stent and 1 patient left pneumonectomy. One patient died of sudden massive hemoptysis 26 d after operation. Intraoperative complications were found in 2 patients. Others had a good recovery after operation. Patients were followed up for 11 months to 14 years. Eight patients were followed up less than 5 years postoperatively, one patient died of sudden massive hemoptysis 14 months after operation, while others survived; 21 patients were followed up more than 5 years and 5 patients were lost to follow-up. Conclusion Surgical resection is recommended for tracheal and main bronchial tumors. Patients with small benign tumor may choose local tracheal resection; tracheal segmental resection and end-to-end anastomosis is the most common surgical treatment. Patients with more than half of the whole length of tracheal defects or in the risk of anastomotic ischemic necrosis may be suggested to receive tracheal reconstruction.

关 键 词：气管肿瘤 主支气管肿瘤 外科治疗 气道重建 肺组织瓣 

分 类 号：R734.1[医药卫生—肿瘤]