心包内处理肺血管及心房部分切除治疗中心型肺癌

１９８７年５月至１９９３年１２月对１６例较晚期肺癌采用心包内处理肺血管及心房部分切除的方法作了全肺切除术，肿瘤均为中心型。ＣＴ扫描显示隆突下或主肺动脉窗淋巴结肿大者占５０％，术中见肺动脉，肺静脉均受累者８例，肺静脉受累者６例，２例作左心室部分切除，１５例恢复良好，１例术中大出血致心脏停搏，复苏后并发脑水肿昏迷死亡。我们认为，心包内处理肺血管全肺切除提高了手术切除率，且手术过程较安全可靠，作者对这种

Treatment of central type lung cancer with intrapericardial pneumonectomy

From May 1987 to December 1993, 16 patients underwent pneumonectomy for late stage lung cancer.Intrapericardial ligation of pulmonary vessels was performed in 14 patients and resection of involved portions of the atria in 2 patients.All of the carcinoma are central type.CT scanning showed enlargement of subaortic lymph node in 8 patients(50%).Operative exploration found that both pulmonary artery and pulmonary vein were involved in 8 cases,only pulmonary vein involved in 6 cases.Fifteen patients rapidly recovered without complication.Cardiac arrest occurred in one patient because of severe operative bleeding,and after cardiopulmonary resucitation the patient died of cerebral edema. It is thought that pneumonectomy with intrapericardial management of the pulmonary vessels is a safe and reliable procedure,which increases resection rate.Operative techniques are also discussed in this paper.