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目的 总结 3 0 4例支气管肺动脉袖状成形肺叶切除术或合并其它心脏大血管切除重建术治疗侵犯肺动脉干的局部晚期肺癌的临床疗效。方法 1983年 2月至 2 0 0 1年 12月 ,对 3 0 4例肺癌患者施行支气管肺动脉袖状成形肺叶切除或合并其它心脏大血管切除重建术。支气管肺动脉袖状成形左上叶切除术 199例 ;支气管肺动脉袖状成形右肺上叶切除术 2 1例 ;支气管肺动脉袖状成形右肺中上叶切除术 14例 ;支气管肺动脉袖状成形左上叶切除合并部分左心房切除 8例 ;支气管肺动脉袖状成形右肺上叶切除合并上腔静脉切除人造血管重建术 2 9例 ;支气管肺动脉袖状成形右肺中上叶切除合并上腔静脉切除人造血管重建术 2 1例 ;支气管肺动脉袖状成形右肺中上叶切除、气管隆凸切除重建 ,合并上腔静脉切除人造血管重建术 11例 ;右肺动脉干部分切除、肺动脉圆锥大部切除 ,人造血管右肺动脉干、肺动脉圆锥重建合并左全肺切除术 1例。结果 本组手术死亡 3例 ,死亡率为 1%。发生手术并发症 64例次 ,发生率为 2 1.0 5 %。术后 1、3、5和 10年生存率分别为 81.75 %、60 .14 %、3 7.2 1%和 2 4.3 9%。结论 支气管肺动脉袖状成形肺叶切除或 /和合并其它心脏大血管切除重建术均能明显改善局部晚期肺癌的预后 ,提高治愈率和生存率。
Objective To summarize the clinical curative effect of 304 cases of bronchial pulmonary artery sleeve lobe resection or other cardiac revascularization in the treatment of locally advanced lung cancer invading the pulmonary trunk. Methods From February 1983 to December 2001, 304 patients with lung cancer underwent sleeve lobe resection of bronchial pulmonary artery or combined with other cardiac revascularization. 199 cases of bronchial and pulmonary artery sleeve left upper lobe resection in 199 cases; bronchial pulmonary artery sleeve lobe upper lobe resection in 21 cases; bronchial pulmonary artery sleeve right middle lobe resection in 14 cases; bronchial pulmonary artery sleeve left upper lobe resection A total of 29 cases were divided into two groups: left atrium and left atrium in 8 cases; bronchial and pulmonary artery sleeve right upper lobe resection combined with superior vena cava resection 29 cases; bronchial and pulmonary artery sleeve right middle lobe resection combined with superior vena cava resection of artificial vascular reconstruction Surgery in 21 cases; bronchial pulmonary artery sleeve right upper lobe resection of the lung, resection of the reconstruction of the bronchial carotid, combined with superior vena cava resection of artificial vascular reconstruction in 11 cases; right common pulmonary artery resection, pulmonary conus mostly removed, Pulmonary artery, conization of pulmonary artery with left pneumonectomy in 1 case. Results The group died of surgery in 3 cases, the mortality rate was 1%. There were 64 cases of surgical complications, the incidence was 2 1.05%. The 1,3,5 and 10 year survival rates were 81.75%, 60.14%, 32.21% and 22.39%, respectively. Conclusions Bronchial pulmonary artery sleeve lobe resection or / and other cardiac revascularization can significantly improve the prognosis of locally advanced lung cancer and improve the cure rate and survival rate.