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目的:分析总结通过有计划的或临时的短暂部分肺循环阻断术施行21例Ⅲ期肺部肿瘤手术的体会。方法:1998年9月～2009年1月,通过短暂部分肺循环阻断结合成形术完成肺癌切除。其中肺叶切除18例,袖状切除3例。结果:所有手术均短暂部分阻断肺循环并行肺叶切除,阻断时间短于30min,无死亡,无严重并发症。平均手术时间2.5h,平均胸腔引流200ml,平均术后住院12天。结论:通过短暂部分肺循环阻断结合成形术,进行肺叶切除治疗Ⅲ期肺癌在技术上是可行的,较同类型非阻断手术具有切除率高、出血少、创伤小,避免全肺切除。清扫相关淋巴结更容易、彻底。处理相关肺叶动、静脉、支气管顺序更灵活等临床实用价值,符合肺癌外科治疗的原则,实现了该期肿瘤的积极外科干预的可能性。
OBJECTIVE: To analyze and summarize the experience of 21 cases of stage III pulmonary tumor surgery through planned or temporary transient partial pulmonary blockade. Methods: From September 1998 to January 2009, resection of lung cancer was completed through a brief partial pulmonary circulation block combined with angioplasty. Among them, there were 18 cases of lobectomy and 3 cases of sleeve resection. Results: In all the operations, pulmonary lobectomy was blocked for a short time. The blocking time was shorter than 30 minutes, no death and no serious complications. The average operation time 2.5h, average chest drainage 200ml, the average postoperative hospitalization 12 days. CONCLUSION: It is technically feasible to treat stage III lung cancer by partial pulmonary embolism with pulmonary embolism. Compared with the same type of non-blocking surgery, it has the advantages of high resection rate, less bleeding, less trauma and no pneumonectomy. Sweep related lymph nodes more easily and thoroughly. To deal with the clinical practical value of pulmonary artery, vein and bronchial sequence which is more flexible and in line with the principle of surgical treatment of lung cancer, and to realize the possibility of active surgical intervention of the tumor in this period.