肺癌切除裁剪式支气管成形的临床疗效分析  

CLINICAL EFFECT ANALYSIS OF THE BRONCHUS CUT OUT AND BRONCHOPLASTY FOR LUNG CANCER

作　　者：刘吉福[1] 任林生[1] 王树寿[1] 薛文平[1] 

机构地区：[1]北京军区总医院,北京100700

出　　处：《解放军医学杂志》2003年第12期1110-1111,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的　探讨袖状支气管切除成形术改进后的临床应用价值和疗效。方法　 2 1例肺癌患者 ,肿瘤在支气管内侵犯范围均超出一叶支气管口 ,排除了叶切除的可能。术中根据肿瘤在支气管内的范围裁剪切除 ,用保留的健康支气管壁成形。结果　术后病理检查 :鳞癌 15例 ,腺癌 4例 ,小细胞癌和类癌各 1例。分期 :Ⅰ期 3例 ,Ⅱ期 12例 ,Ⅲa期 6例。 19例术后恢复顺利 ,2例因急性肺栓塞和应激性溃疡消化道大出血围手术期死亡。无呼吸衰竭发生。 16例术毕和 12例在术后 6～36个月随访中做了支气管镜检查 ,成形的支气管部位黏膜光滑 ,未发现支气管狭窄及肿瘤复发。随访 4～72个月 ,中位生存期 4 2个月 ,5例死于癌。患者术后生活质量良好。结论　肺癌裁剪式支气管成形术近、远期疗效良好 ,提供了肺癌切除支气管成形个性化和灵活的选择术式。Objective To investigate value and effect of the bronchus was cut out and bronchoplasty for lung cancer. Methods Twenty-one patients with lung cancer which all invased out one bronchial orifice and precluded standard lobectomy. The present of endobronchial tumor was cut out according to the lesion region during operation, the bronchoplasty performed by health bronchial wall. Results There were squamous carcinoma in 15 patients; adenocarcinoma in 4; small cell lung cancer and carcinoid each one patient. Staging: stage Ⅰ in 3 patients; stage Ⅱ in 12, stage Ⅲa in 6. The 19 patients were uneventful after operation. The 2 cases died from acute pulmonary embolism or gastric irritable ulcer with large bleeding in perioperation. Respiratory failure in all patients had not occurred. Bronchoscopy performed immediately after operation in 16 patients and in the period of following up 6-36 months in 12 patients, the mucosa of bronchoplastic sites was smooth, no bronchial stenosis and no tumoral relapse.The period of following-up was 4-72 months, median survival 42 months after operation. Five patients died from the metastases or relapse. Life time in survival patients was well. Conclusion The bronchial resection by cut out and bronchoplasty for lung cancer had a good results in near future and long period, and proved individualized and adapted selective type of resection for bronchoplasty of lung cancer.

关 键 词：肺肿瘤 肺外科手术 支气管成形 

分 类 号：R734.2[医药卫生—肿瘤]