心包内处理血管全肺切除治疗局部晚期肺癌的疗效

目的探讨局部晚期肺癌手术中心包内处理血管的安全性和远期疗效。方法回顾性分析1998年1月至2006年11月因中央型肺癌行一侧全肺切除78例。其中心包内处理血管17例(Ⅰ组),61例为标准一侧全肺切除(Ⅱ)组,比较两组围手术期主要并发症(心律失常及支气管残端瘘)及术后1、3及5年生存率。结果两组均无手术死亡。主要并发症:1.心律失常:Ⅰ组9例(52.94%),Ⅱ组11例(18.03%);2.支气管残端瘘:Ⅰ组0例,Ⅱ组3例(4.92%)。1、3、5年生存率:Ⅰ组分别为70.59%、35.39%、17.65%;Ⅱ组分别为72.13%、34.43%、21.31%。结论心包内处理血管一侧全肺切除术后患者心律失常发生率有上升(P<0.01),但并不增加围手术期病死率,不影响生存率。该手术方式提高了肺癌切除率,减少了手术探查率,为局部晚期肺癌综合治疗创造了条件,值得临床推广。

Intrapericardial pneumonectomg for lung cancer at local and late stage

Objective To study the securty and effects of intrapericardial pneumonetomy for lung cancer.Methods To review and analyze the clinical date of 17 cases of the intrapericardial pneumonctomy.Results Intrapericardial pneumonectomy was done in 21.79% of all pneumonectomy of lung cancer (78 cases) from 1998 to 2006.there was no operative mortality,the cardiac arrhythmia in postoperation was 9 cases (52.94),the 1.3 and 5-year survival tates were 70.59%,35.29% and 17.65%.Conclusion The method of intrapericardial pneumonetomy was secure though the complications of cardiac arrhythmia in postoperation rose.The operation mortality and survival had not change.This method can increase the opportunity of operation and reduce mere exploratomy.It may be performed routinely.