论文部分内容阅读
目的总结肺癌侵犯气管及心血管的外科治疗的经验。方法回顾性分析本院1991年6月~2006年12月外科收治的局部晚期肺癌75例。其中男性57例,女性18例,中位年龄54岁。右肺支气管或隆突重建49例,左肺支气管或隆突重建26例。同期肺动脉成形26例,左心房部分切除8例,上腔静脉置换或侧壁切除6例。临床分期(U ICC1997):ⅡB期12例,ⅢA期30例,ⅢB期33例。本组49例术前接受1~3周辅助化疗。结果本组无住院死亡。术后发生各类早期并发症25例(33.3%),其中肺不张11例,胸腔感染6例,呼吸功能不全5例,心功能不全3例,经治疗后均痊愈。本组失访8例,其余67例随访3个月~16年,1、3、5年生存率分别为72.3%、52.5%、26.8%。结论外科治疗侵犯支气管、隆突、肺动脉、上腔静脉及左心房的局部晚期肺癌,能明显提高患者术后生存率和生活质量。
Objective To summarize the experience of lung cancer invasion of tracheal and cardiovascular surgical treatment. Methods A retrospective analysis of 75 cases of locally advanced lung cancer admitted from June 1991 to December 2006 in our hospital. There were 57 males and 18 females, with a median age of 54 years. In the right lung, 49 cases were reconstructed by bronchus or carina, 26 cases were reconstructed by left lung bronchus or carina. In the same period, 26 cases of pulmonary artery angioplasty, partial resection of the left atrium in 8 cases, superior vena cava replacement or resection of the lateral wall in 6 cases. Clinical stage (UICC1997): 12 cases of stage Ⅱ B, 30 cases of stage Ⅲ A, 33 cases of stage ⅢB. The group of 49 patients received 1 to 3 weeks preoperative adjuvant chemotherapy. Results There were no hospitalizations in this group. There were 25 cases (33.3%) of all kinds of early complications after operation, including 11 cases of atelectasis, 6 cases of thoracic infection, 5 cases of respiratory insufficiency, 3 cases of cardiac insufficiency, and recovered after treatment. The group lost 8 cases, the remaining 67 cases were followed up for 3 months to 16 years, 1, 3, 5-year survival rates were 72.3%, 52.5%, 26.8%. Conclusion Surgical treatment of locally advanced lung cancer involving the bronchus, the carina, the pulmonary artery, the superior vena cava and the left atrium can significantly improve the postoperative survival rate and quality of life.