隆凸切除重建、支气管肺动脉成形术治疗中心型肺癌

背景与目的 支气管成形在切除肿瘤的同时又可以最大限度地保留肺组织。目前已成为肺功能不全不能耐受全肺切除术时所选择的术式。本文总结79例隆凸切除、支气管肺动脉成形术治疗中心型肺癌的经验。方法 1987年3月至2005年3月，施行左支气管肺动脉成形34例，右支气管肺动脉成形45例。其中隆凸切除重建14例。结果 本组无手术死亡。发生手术并发症28例，发生率为35．4％，术后1、3、5年生存率分别为86．1％．55．2％、32．1％。结论 隆凸、支气管、肺动脉成形术三者灵活应用，可扩大肺癌手术适应证，减少全肺切除比例，同时改善患者术后生活质量，取得满意的治疗效果。

Carinal resection and reconstruction, and bronchoplasty and pulmonary arterioplasty in the treatment of centraltype lung cancer

Bacground and objective Boonchoplasty can not only remove tumor but also reserve lung tissue maximally, and it becomes an alternative choice for patient with poor pulmonary function who could not accept pneumonectomy. The aim of this study is to summarize the experience of carinal resection and reconstruction, bronchoplasty and pulmonary arterioplasty in the treatment of central-type lung cancer. Methods From March, 1987 to March, 2005, A total of 79 patients with central-type lung cancer underwent operation. The operations included: left bronchoplasty (34 cases) combined with pulmonary arterioplasty in 10 cases and partial resection of left atrium in 3 cases; right bronchoplasty (45 cases) combined with carinal resection in 14 cases and segmentplasty in 5 cases, pulmonary arterioplasty in 5 cases, partial resection of superior vena cava wall in 5 cases. Results There were no perioperative deaths. Twenty-eight cases (35.4%) had postoperative complication. The 1-, 3-and 5-year survival rate were 86.1%, 55.2% and 32.1% respectively. Conclusion Proper selection of carinal resection, bronchoplasty and pulmonary arterioplasty can expand the indications. They can reduce the ratio of pneumonectomy and improve the postoperative quality of life and the prognosis of lung cancer patients.