原发性气管肿瘤的外科治疗  

Clinical analysis of surgical treatment of primary tracheal tumors

作　　者：程贵余[1] 张汝刚[1] 张德超[1] 汪良骏[1] 张大为[1] 黄国俊[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院胸外科,北京100021

出　　处：《中华外科杂志》2003年第11期823-826,共4页Chinese Journal of Surgery

摘　　要：目的　总结外科手术治疗原发性气管肿瘤的临床经验。　方法　回顾性分析我科196 8～ 2 0 0 1年 70例原发性气管肿瘤的外科治疗资料。　结果　气管节段切除 39例 ,隆凸切除 13例 ,气管侧壁切除 10例 ,肿瘤局部剔除 5例 ,全肺切除 1例 ,开胸探查 2例。并发症发生率 31% (2 2 / 70 )。气管切除与重建术后 30d内死亡率 8% (4 / 5 2 )。良性肿瘤 14例 ,恶性肿瘤 5 6例。其中腺样囊性癌和鳞癌是最常见的类型 ,分别为 4 5 % (2 5 / 5 6 )和 2 3% (13/ 5 6 )。良性肿瘤随诊平均 5 7年。恶性肿瘤切除术后 5、10年生存率分别为 6 4 % (2 1/ 33)和 5 4 % (14 / 2 6 )。　结论　手术切除是治疗气管肿瘤最有效的方法。气管节段切除是治疗气管恶性肿瘤的主要术式 ,良性肿瘤可以考虑保守的术式。降低手术并发症是取得良好手术疗效的关键。Objetive To summarize the clinical experiences in treating primary tracheal tumors by surgery. Methods The clinical data concerning 70 surgically treated patients between 1968 and 2001 were retrospectively analyzed. Results There were 39 sleeve tracheal resections, 13 carinal resections, 10 lateral tracheal wall resections, 5 local enucleations, and 1 pneumonectomy. The tumors in 2 patients were unresectable. The morbidity rate was 31% (22/70) and operative 30-day mortality for resection with primary reconstruction was 8%(4/52). The tumors were benign in 14 and malignant in 56 cases. The most common malignant tumors were adenoidcystic carcinoma (45%) and squamous cell carcinoma (23%). The cases of benign tracheal tumors were followed up for an average of 5.7 years. After resection for malignant tumors, the overall 5- and 10- year survival rates were 64% (21/33) and 54% (14/26), respectively. Conclusions Surgical resection is the most effective treatment of tracheal tumors. Tracheal resection and reconstrution is the treatment of choice for primary tracheal tumors. Benign tumors should be resected conservatively with preservation of tracheal parenchyma. The reduction of operative complications are key points of good surgical results.

关 键 词：原发性气管肿瘤 治疗 外科手术 预后 

分 类 号：R734.1[医药卫生—肿瘤]