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目的总结490例原发性支气管肺癌的手术治疗经验。方法回顾分析本科自1978年1月-2003年1月间对490例不同民族肺癌患者手术治疗的临床病理资料和随访结果。结果全组手术切除448例,切除率为91.4%,其中全肺切除76例,肺叶切除372例。术后并发症发生率为10.4%,手术死亡率为0.8%。随访率为85.2%,术后1、3和5年生存率分别为88.1%、56.6%和42.3%。P-TNM分期、淋巴结状况、病理类型与预后有关(P<0.05),而手术方式对预后无显著影响(P>0.05)。结论早期确诊是提高治疗效果的关键,手术治疗仍是治疗肺癌的首选方法,其次配合术后放疗、化疗。严格的围术期管理有助于防止术后并发症的发生。手术治疗的预后与肿瘤的P-TNM分期、病理类型和淋巴结转移有密切关系。
Objective To summarize the experience of surgical treatment of 490 cases of primary bronchogenic carcinoma of the lung. Methods The clinical and pathological data and follow-up results of 490 cases of lung cancer patients from different nationalities from January 1978 to January 2003 were retrospectively analyzed. Results The whole group of 448 cases of surgical resection, resection rate was 91.4%, of which 76 cases of pneumonectomy, lobectomy 372 cases. Postoperative complication rate was 10.4% and operative mortality was 0.8%. The follow-up rate was 85.2%. The 1,3 and 5-year survival rates were 88.1%, 56.6% and 42.3% respectively. P-TNM stage, lymph node status and pathological type were related to prognosis (P <0.05), but surgical method had no significant effect on prognosis (P> 0.05). Conclusion Early diagnosis is the key to improve the therapeutic effect. Surgical treatment is still the first choice for the treatment of lung cancer, followed by postoperative radiotherapy and chemotherapy. Strict perioperative management helps prevent postoperative complications. Surgical treatment of prognosis and tumor P-TNM staging, pathological types and lymph node metastasis are closely related.