扩大袖型切除术治疗中央型肺癌30例经验总结  

The experience of 30 extended sleeve lobectomy cases in the treatment of central lung cancer

作　　者：潘旭峰[1] 顾畅[1] 傅世杰[1] 杨骏[1] 赵珩[1] PanXufeng;GuChang;FuShijie;YangJun;ZhaoHeng(Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai200030, ChinaDepartment of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai200030, China)

机构地区：[1]上海交通大学附属胸科医院胸外科,200030

出　　处：《中华胸部外科电子杂志》2017年第4期204-208,共5页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

基　　金：上海市卫计委局青课题(20144Y0169)

摘　　要：目的探讨扩大袖型切除对中央型肺癌的治疗效果。方法 2014年3月—2015年9月,上海市胸科医院对30例中央型肺癌患者行经扩大袖型切除术治疗的,对相关临床资料、手术方式、并发症以及随访情况做一总结。结果全组患者无术中或住院期间死亡病例,24例(80.0%)患者取得彻底(R0)切除。所有患者中,鳞癌占绝大多数(20/30,66.7%),其次为腺癌(6/30,20.0%)。从手术切除范围来看,涉及一叶加段切的扩大袖型切除14例(46.7%),涉及两叶的扩大袖型切除16例(53.3%)。共有14例(46.7%)患者发生并发症,其中术中或术后输血5例,术后不同程度皮下气肿、心律失常、肺部感染各3例,支气管胸膜瘘和肺不张各2例,乳糜胸1例。患者1、2、3年总生存率分别为80.0%、56.3%和44.4%。结论对于局部晚期中央型肺癌,尤其肺功能不佳的患者,扩大袖型切除可以作为全肺切除术的一种代替治疗手段。Objective To discuss the surgical outcomes of extended sleeve resection for centrally located lung cancer.MethodsA retrospective study of30patients with centrally located lung cancer who received extended sleeve resection from March2014to September2015in Shanghai Chest Hospital.The corresponding data including clinical presentation,operation procedure,perioperative complications and follow up examinations were reviewed.ResultsThere was no intraoperative or perioperative death.24of30patients underwent complete resection.In all patients,squamous cell carcinoma accounted for the vast majority(20/30,66.7%),followed by adenocarcinoma(6/30,20.0%).From the scope of surgical resection,there were14cases(46.7%)involving enlarged lobectomy with one lobed plus segmental resection,and16cases(53.3%)involving enlarged two lobed resection.In our study,there were14patients who suffered from postoperative complications,including transfusion in5patients,subcutaneous emphysema in3patients,arrhythmia in3patients,pulmonary infection in3patients,bronchopleural fistula in2patients,pulmonary atelectasis in2patients and chylothorax in1patient.During follow up period,the survival rates for1year,2year and3year were80%,56.3%and44.4%,respectively.ConclusionsFor patients with centrally located lung cancer,if technique available,extended sleeve resection is an alternative to pneumonectomy.

关 键 词：扩大袖型切除术 中央型肺癌 并发症 预后 

分 类 号：R734.2[医药卫生—肿瘤]