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目的 分析气管隆凸、支气管成形肺切除术治疗中心型肺癌的近期和远期疗效。方法 自 1985年 4月到 1999年 5月共手术治疗原发性肺癌 90 2例 ,其中气管隆凸、支气管成形肺切除术 94例 ,即支气管成形术 80例 ,隆凸切除 14例。结果 术后发生肺不张 9例 ,心律失常 2例 ,吻合口瘘 1例 ,手术死亡率为 0。 1年生存率为 83 .1% ( 74/89) ,3年生存率 5 8.3 % ( 3 5 /5 6) ,5年生存率 3 4 .0 % ( 18/5 3 )。ⅠB期 5年生存率 66.7% ( 6/9) ,ⅡB期 40 % ( 6/15 ) ,ⅢA期 2 1.1% ( 4 /19)。讨论了病例选择 ,淋巴结廓清 ,支气管和肺血管处理 ,以及上腔静脉替换和修补。结论 支气管成形术治疗肺癌的疗效取决于疾病的分期和正确的适应症选择 ,术中的根治切除和术后的综合治疗。
Objective To analyze the short-term and long-term efficacy of tracheal protuberance and bronchial resection in the treatment of central lung cancer. Methods From April 1985 to May 1999, a total of 90 cases of primary lung cancer were treated surgically, including 94 cases of tracheal protuberance and bronchiectomized pneumonectomy, ie 80 cases of bronchoplasty and 14 cases of kyphoplasty. Results There were 9 cases of postoperative atelectasis, 2 cases of arrhythmia, 1 case of anastomotic leakage, and 0 operative mortality. The one-year survival rate was 83.1% (74/89), the three-year survival rate was 58.3% (3 5 /5 6), and the 5-year survival rate was 34.0% (18/5 3). The 5-year survival rate was 66.7% (6/9) in IB phase, 40% (6/15) in IIB phase, and 1.1% (4/19) in IIIA phase. Case selection, lymph node dissection, bronchial and pulmonary vascular treatment, and superior vena cava replacement and repair were discussed. Conclusion The efficacy of bronchoplasty in the treatment of lung cancer depends on the stage of the disease and the correct indications, the radical resection and postoperative comprehensive treatment.