心包内处理血管全肺切除治疗中晚期肺癌32例

目的　探讨经心包内处理血管的全肺切除术在提高肺癌手术疗效中的作用。方法　对 32例肺癌病人行心包内处理血管的全肺切除术 ,占同期全肺切除的 43 % (32 / 74)。结果　手术死亡 1例。主要并发症是呼吸衰竭、肺水肿、脓胸和心律失常 ,发生率为 2 8.1 %。 1、3、5年生存率分别为 80 .6 %、35 .5 %、2 2 .6 % ,治疗组的并发症的发生率、死亡率及预后与标准肺切除术相比无显著性差异 (P >0 .0 5)。结论　心包内处理血管的全肺切除可提高肺癌的切除率 ,手术的根治性及安全性 ,改善患者的生存质量。

Treatment of Pneumonectomy Via Pericardium for Patients with Lung Cancer in Middle or Later Period:A Report of 32 Cases

Objective To evaluate the effect of pneumonectomy via pericardium for patients with lung cancer in middle or later period. Methods Thirty-two patients with lung cancer in middle or later period received pneumonectomy via pericardium. It was 43% of all pneumonectomies for lung cancer. Results One patient died after operation. Chief complications were respiratory failure, pulmonary edema, empyema and cardiac arrhythmia. The morbidity rate was 28 %. 1-, 2-, 3-year survival rate were 80.6%, 35.5% and 22.6% respectively. There were no significant difference in mortality and morbidity between pneumonectomy via pericardium and the routine pneumonectomy (P>0.05). Conclusions Pneumonectomy via pericardium can improves the resectable rate and the quality of life of patients with cancer in middle or late period.