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目的:总结和探讨原发性气管、隆突肿瘤外科治疗经验及治疗效果。方法:回顾性分析2007年1月2011年9月收治的23例行外科治疗的气管及隆突原发性肿瘤患者的临床资料,总结外科治疗方法及效果。结果:20例行气管环形切除加端-端吻合术,1例行袖式右全肺切除术(左主支气管气管端端吻合),2例行隆突切除及气管与支气管吻合重建隆突。体外循环辅助3例。术后病理示腺样囊性癌15例,黏液表皮样癌6例,鳞状细胞癌2例。气管切缘均未见肿瘤残存。全组患者均无围术期死亡,手术并发症5例。术后随访6个月-5年,死亡1例(4.3%),生存至今22例(95.7%),生存者均无肿瘤复发。结论:手术切除是治疗气管及隆突肿瘤的有效方法,病理类型及切除范围对患者术后远期生存率有很大影响,合理应用体外循环技术可提高手术安全性。
OBJECTIVE: To summarize and discuss the experience of surgical treatment of primary tracheal and carina tumor and its therapeutic effect. Methods: The clinical data of 23 traumatic patients with tracheobronchial primary tumors treated in our hospital in January 2007 and September 2011 were analyzed retrospectively. The surgical methods and effects were summarized. Results: Twenty patients underwent endotracheal resection combined with end-to-end anastomosis, one underwent sleeve right pneumonectomy (left main bronchial end-to-end anastomosis), two underwent resection of the carina and reconstruction of the carina by bronchial anastomosis. 3 cases assisted by cardiopulmonary bypass. Postoperative pathology showed adenoid cystic carcinoma in 15 cases, mucoepidermoid carcinoma in 6 cases, squamous cell carcinoma in 2 cases. Tracheotomy were not seen tumor resection margin. All patients had no perioperative deaths, 5 cases of complications. The patients were followed up for 6 months to 5 years, 1 died (4.3%) and 22 (95.7%) survived. There was no tumor recurrence in survivors. Conclusion: Surgical resection is an effective method for the treatment of tracheobronchial tumor. The pathological type and resection range have a great influence on the postoperative long-term survival rate of patients. The reasonable application of extracorporeal circulation technique can improve the operation safety.