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目的 探讨肺叶加支气管袖状切除和气管隆凸切除重建术对治疗中央型肺癌的优越性。方法 总结并分析我院自1989～1997年间23例接受该类手术的肺癌患者的临床资料。结果 本组并发症发生率为34.8%(8/23),主要为气管内出血(3例)和肺部感染(2例)。所有患者术后配合化疗和/或放疗,全组1、3及5年生存率分别为91.3%(21/23)、68.7%(11/16)及45.5%(5/11)。2例术后出现肺不张并发感染致通气功能障碍。结论 肺叶加支气管袖状切除和气管隆凸切除重建术治疗中央型肺癌,不仅能最大限度地保留健康肺组织和肺功能,而且能较彻底地切除病变,达到治疗的目的。随着麻醉技术的进展,该类术式手术死亡率明显降低,且并发症较少,值得重视和推广。
Objective To investigate the superiority of treatment of central lung cancer by adding bronchial sleeve resection and tracheal resection and reconstruction. Methods We summarized and analyzed the clinical data of 23 patients with lung cancer undergoing this type of surgery in our hospital from 1989 to 1997. Results The complication rate in this group was 34.8% (8/23), mainly endotracheal hemorrhage (3 cases) and pulmonary infection (2 cases). All patients received postoperative chemotherapy and/or radiotherapy. The overall 1-, 3-, and 5-year survival rates were 91.3% (21/23), 68.7% (11/16), and 45.5% (5/11). Two cases of postoperative atelectasis complicated with ventilatory dysfunction. Conclusions Lung plus bronchial sleeve resection and tracheal tube resection and reconstruction for central lung cancer can not only retain healthy lung tissue and lung function to the maximum extent, but also completely remove the lesions and achieve the purpose of treatment. With the development of anesthesia technology, the mortality rate of this type of surgical operation is significantly reduced, and there are fewer complications, which deserves attention and promotion.