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1.
原发性肺腺癌及其外科疗效 总被引:1,自引:0,他引:1
1983年6月至1991年12月,手术治疗原发性肺腺癌115例,占同期肺癌手术27.3%。术后1、3、5年生存率分别为67.0%、35.4%、21.8%,无手术死亡,本病发生率日趋上升,误诊率高达67.8%;根治性手术是重要治疗手段,但不能控制潜在性微转移灶。作者就其独特临床特点、影响疗效因素、N2淋巴结清除以及全身综合治疗等有关问题进行讨论。 相似文献
2.
急性坏死性胰腺炎外科治疗20年经验总结 总被引:4,自引:0,他引:4
总结了1974年8月 ̄1994年11月243例急性坏死性胰腺炎外科治疗的经验。按治疗观点及治疗方式分为三个阶段。第一阶段1974年8月 ̄1987年12月为针对胰腺坏死作早期彻底切除坏死组织手术,辅以“三造瘘”、“创口敞开”、“局部灌洗”等措施。治愈率为61.3%。第二阶段1988年1月 ̄1991年6月以坏死是否伴有感染为指征,对有感染者作手术治疗,治愈率67.1%;对非感染者作保守治疗,治愈率85 相似文献
3.
23例肝脏小肝细胞癌的术后疗效分析 总被引:1,自引:0,他引:1
我院1985年1月至1994年2月,手术切除的23例直径〈3cm小肝细胞癌,就其临床病理特点进行了分析。术后1年生存率为91.3%,3年为79.1%,5年为67.8%,预后明显优于一般肝癌,本文对小肝细胞癌的生物学特性,肿瘤包膜以及血清甲胎蛋白浓度等进行了讨论。 相似文献
4.
形状记忆合金网状支架治疗前列腺增生症 总被引:75,自引:1,他引:75
1993年8月~1994年8月利用镍钛形状记忆合金网状支架和自行研制的置入器治疗高危前列腺增生症67例。其中61例一次治疗成功,56例(91.8/)术后立即自行排尿,5例术后1~12周内恢复自主排尿,总有效率91.04%(61/67)。24例随访3个月以上,前列腺症状积分(I-PSS)从术前28.79±3.79减少到8.92±3.50(P<0.001),最大尿流率从术前1.87±2.81增加到10.17±1.25m1/s(P<0.001),有显著性差异。本研究表明镍钛形状记忆合金网状支架治疗前列腺增生症安全、有效,近期疗效满意,中远期疗效正在观察研究中。 相似文献
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6.
我科自1991年5月~1996年10月,手术治疗症状重、保守治疗无效的腰椎间盘突出症118例,其中手术证实并腰椎管狭窄47例,优良率93.6%,分析如下。临床资料本组男31例,女16例;年龄26~67岁。病程3月~8年。一侧下肢痛伴小腿外侧酸胀,麻木... 相似文献
7.
前列腺癌130例治疗分析 总被引:16,自引:1,他引:15
为了提高前列腺癌的治疗效果,从1989年1月至1995年5月,分别采用去势治疗和根治手术治疗前列腺癌107例和23例,观察随访2~78个月,平均315个月,随访率738%。根治术组的1、2、3、5年生存率分别为714%、667%、500%和333%,去势组则分别为679%、512%、297%和108%。两组死亡病例的生存期平均为174和260个月,但根治术组的病例生存质量较差。结果认为:根治手术提高了生存率,但一定程度降低了生存质量。主张对于A期患者,采用前列腺包膜内切除,分化差的小肿瘤及时行根治手术;B期患者,只要患者条件允许,根治最为适宜;C1期患者,预期寿命长,亦可采用根治术;C2期和D期患者仅适用去势治疗。 相似文献
8.
作者自1991年5月至1992年8月经皮下埋入式多功能化疗泵,肝动脉、门静脉阿霉素、丝裂霉素双灌注治疗合并门静脉癌栓的晚期肝癌19例、本文详述了置管的方法和治疗结果。本组19例中6例癌栓消失,10例近期(3个月内)肿瘤缩小;14例肿瘤缩小,中位缩小率67.1%,部分缓解率58.8%;11例生存期超过6个月。该法为合并门静脉癌栓的晚期肝癌提供了有价值的治疗方法。 相似文献
9.
原发性肝细胞癌侵入肝胆管的外科治疗 总被引:3,自引:2,他引:3
目的 探讨原发性肝细胞癌侵入肝胆管引起阻塞性黄疸的外科治疗效果.方法 23例病人均接受外科手术治疗,单纯胆管癌栓清除+T管引流10例;胆管癌栓清除+肿瘤切除10例,其中左半肝切除8例,右半肝切除1例,右肝不规则切除4例。结果 手术死亡3例,存活3 ̄6个月3例,半年 ̄1年4例占17.4%,1年 ̄2年8例占34.8%,2年 ̄3年4例占17.4%,单纯胆管癌栓清除平均存活时间6.5个月,肝叶切除17.3 相似文献
10.
皮下埋入式多功能化疗泵肝动脉门静脉双灌注治疗晚期肝癌 总被引:4,自引:0,他引:4
作者自1991年5月至1992年8月经皮下埋入式多功能化疗泵,肝动脉,门静脉阿霉素,丝裂霉素双灌注治疗合并门静脉癌栓的晚期肝癌19例,本文详述了置管的方法和治疗结果。本组19例中6例癌栓消失,10例近期(3个月内)肿瘤缩小,14例肿瘤缩小,中位缩小率67.1%,部分缓解率58.8%;11例生存期超过6个月。该法为合并门静脉癌栓的晚期肝癌提供了有价值的治疗方法。 相似文献
11.
Results of surgical treatment in bronchioloalveolar carcinoma 总被引:1,自引:0,他引:1
L Heikkil? 《Annales chirurgiae et gynaecologiae》1986,75(4):183-191
The study relates to patients with bronchioloalveolar carcinoma who had undergone operation. On reassessment of histological specimens, 92 patients were considered to have been suffering from bronchioloalveolar carcinoma. Bronchioloalveolar carcinoma was further classified according to histological findings as typical or of mixed type. The latter included cases on which there was differentiation towards pulmonary adenocarcinoma. A third group consisted of 32 cases of peripheral pulmonary adenocarcinoma originally diagnosed as bronchioloalveolar carcinoma. Pulmonary tuberculosis was found to have occurred oftener in bronchioloalveolar carcinoma cases than in mixed bronchioloalveolar cases (p less than 0.005). A history of pneumonia was commoner in mixed bronchioloalveolar and adenocarcinoma patients than in bronchioloalveolar patients (p less than 0.05). Lobectomy or more conservative resection had been possible in the majority of cases. There had been no surgical or hospital mortality. No differences existed between the groups as regards surgical treatment, postoperative radiotherapy or chemotherapy. Local recurrence was commoner in bronchioloalveolar patients than in mixed bronchioloalveolar patients (p less than 0.001) or adenocarcinoma patients (p less than 0.025). Mixed bronchioloalveolar and adenocarcinoma patients had distant metastases oftener than bronchioloalveolar patients (p less than 0.025 and p less than 0.001). Adenocarcinoma patients also had more metastases than mixed bronchioloalveolar patients, but the difference was not statistically significant. Most metastases (82%) were discovered within three years of operation. The incidence of local recurrences increased from three years after operation. The five-year survival rate was 57% in the bronchioloalveolar group, 45% in the mixed bronchioloalveolar group and 17% in the adenocarcinoma group.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
12.
G Celoria J S Steingrub M Vickers-Lahti D Teres K L Stein M Fink P Friedmann 《Archives of surgery (Chicago, Ill. : 1960)》1990,125(8):1036-1039
A prospective study of 126 surgical patients from two institutions was undertaken to assess the impact of pulmonary artery catheterization in surgical intensive care units. Before catheterization, surgical residents were asked to predict pulmonary artery wedge pressure, cardiac output, systemic vascular resistance, and plan of therapy. After catheterization, each chart was reviewed by a panel of intensive care specialists and a general surgeon. Correct classification for the hemodynamic variables ranged from 47% to 55%. Catheterization results prompted a major change in therapy in 50% of patients. The data suggest that hemodynamic variables obtained from pulmonary artery catheterization improve the accuracy of bedside evaluation and lead to alteration in therapy, particularly in patients whose pulmonary artery wedge pressure predictions were poor. 相似文献
13.
Danner BC Didilis V Dörge H Mikroulis D Bougioukas G Schöndube FA 《Interactive Cardiovascular and Thoracic Surgery》2008,7(5):771-776
Invasive pulmonary aspergillosis is a severe complication in immunosuppressed patients. Surgical resection can be curative in certain patients after antifungal treatment. Over a 7-year period, ten patients with suspected invasive pulmonary aspergillosis of two university hospitals were retrospectively reviewed. A literature review was undertaken. Patient's age was 48.1 years (mean); the cause of immunosuppression was a hematological disease with consecutive therapy in seven patients and chronically corticoid therapy in three patients. After an antifungal therapy, surgical resection was performed with lobectomy/segmentectomy in 60% and with wedge-resection in 40%. Postoperative course were uneventful in seven patients, two patients died due to infectional circumstances, and one patient was reoperated because of empyema. The underlying disease marked long-term follow-up. Resection of focal pulmonary invasive aspergillosis can be curative. Clinical circumstances and dissemination must be taken into consideration to indicate surgery. To point out the best pathway randomised prospective studies are necessary. 相似文献
14.
E D Staren C Salerno A Rongione T R Witt L P Faber 《Archives of surgery (Chicago, Ill. : 1960)》1992,127(11):1282-1284
Thirty-three patients treated primarily with surgical excision of pulmonary metastases from breast cancer were compared with 30 patients treated primarily with systemic chemohormonal therapy. Treatment for patients in the surgical group included pulmonary resection alone in 20, resection plus adjuvant systemic therapy in nine, and resection plus adjuvant radiation therapy in four. Treatment for patients in the medical group included systemic therapy alone in 22 and systemic therapy plus local radiation therapy in eight. Mean survival in the surgical group was significantly longer than that in the medical group, even when only those patients who manifested single pulmonary nodules were compared (58 months vs 34 months). The overall 5-year survival rate after treatment of lung metastasis was significantly greater for the surgical group than for the medical group (36% vs 11%). The results of this study indicate that surgical resection should be considered in patients with breast cancer who develop operable pulmonary metastases without evidence for concomitant extrapulmonary disease. In selected patients, such therapy may result in a survival benefit. 相似文献
15.
肺转移瘤的外科治疗(附40例报告) 总被引:7,自引:1,他引:6
报告外科治疗肺转移瘤40例,其中肉瘤肺转移13例,癌肺转移27例,无手术死亡。术后1、3、5、7和10年生存率分别为89.5%、38.9%、28.6%、16.6%和7.6%。肉瘤和癌肺转移瘤切除后5年生存率分别为25.0%和31.3%。作者对手术适应证、手术方法和影响预后的因素进行了讨论。主张对肺转移瘤不论是孤立性或单侧多发性,还是双侧肺转移瘤均应积极争取外科治疗。在临床上估计可以切除且及早切除肺转移瘤可能获得较好治疗效果时,就不必去考虑转移瘤的倍增时间(TDT)和无瘤间期(DFI)。 相似文献
16.
Hiromichi?Ito Alexander?Perez David?C.?Brooks Robert?T.?Osteen Michael?J.?Zinner Francis?D.?MooreJr. Stanley?W.?Ashley Edward?E.?Whang
Small bowel malignancies are rare. The aims of this study were to evaluate the outcomes associated with surgical therapy for
small bowel cancers and to define prognostic factors. The medical records of 96 consecutive patients with primary small bowel
cancer (excluding lymphoma) treated at our institution over a 20 year period were reviewed. Survival was analyzed using the
Kaplan-Meier method (mean follow-up period 57 months). Mean patient age was 56 years, and 58% of patients were male. Sixty
percent of patients had an adenocarcinoma, 21% had a sarcoma, and 19% had a carcinoid tumor. The percentages of patients who
underwent complete (curative) resection were 51%, 90%, and 50% for those with adenocarcinoma, sarcoma, and carcinoid tumor,
respectively. For patients with adenocarcinoma who underwent curative resection, tumor (T) and node (N) stages were significant
prognostic factors predicting overall survival. For patients with sarcomas who underwent curative resection, tumor grade was
a significant prognostic factor predicting overall survival. The prognosis for patients with small intestinal carcinoid tumors
is uniformly favorable. The prognosis for patients with sarcomas and adenocarcinomas is generally poor, although long-term
survival is achieved by patients with favorable prognostic factors.
Presented at the Society of Surgical Oncology Fifty-Sixth Annual Cancer Symposium, Los Angels, California, March 5–9, 2003. 相似文献
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18.
Nakata M Sawada S Yamashita M Saeki H Kurita A Takashima S Tanemoto K 《The Annals of thoracic surgery》2004,78(4):1194-1199
Background
The aim of this study was to identify the clinical characteristics of multiple primary adenocarcinomas and to evaluate the efficacy of surgical treatments.Methods
Three-hundred sixty-nine patients who underwent pulmonary resection for adenocarcinoma from January 1994 to December 2002 were reviewed.Results
Thirty-one patients (8.4%) were determined to have multiple primary adenocarcinomas that could be detected on chest x-rays or computed tomography (CT). Twenty-six patients were synchronous and five patients were metachronous with a median interval of 59.0 months. Forty-nine (72.1%) of the total 68 lesions exhibited ground-glass opacity on high-resolution CT (HRCT). Pathologically well-differentiated adenocarcinoma with mixed bronchioloalveolar pattern was the most common subtype (39.7%). Taking into consideration pulmonary function, size, location, and HRCT findings of the lesions the procedures performed were lobectomy with mediastinal lymph-node dissection for 32 patients, segmentectomy with hilar node dissection for 8 patients, and wedge resection for 28 patients. Of 17 patients with bilateral synchronous cancers, simultaneous bilateral pulmonary resection was performed in 14 patients including simultaneous bilateral video-assisted thoracic surgery (VATS) in 11 patients. After a median follow-up period of 27.7 months, the 3-year overall survival rate was 92.9% and the 3-year disease-free survival rates of synchronous cancer and metachronous cancer were 77.9% and 100%, respectively.Conclusions
The incidence of multiple primary adenocarcinomas was relatively common. Early radiographic detection and surgical excision could yield a favorable prognosis. The use of VATS, even for synchronous bilateral patients, was a safe and beneficial procedure. 相似文献19.
目的探讨子宫内膜癌术后激素替代治疗(HRT)对肿瘤预后的影响。方法收集1983年1月至2005年12月期间,北京协和医院收治的年龄小于50岁、手术绝经的子宫内膜癌患者76例,按照患者的年龄段、接受治疗年限,以1:2匹配研究组和对照组。共收集到术后行HRT的患者17例,设为研究组。匹配未接受HRT的患者34例,设为对照组。对上述51例患者的临床资料进行回顾性分析和统计学检验。结果研究组1例复发(5.9%),对照组4例复发(11.8%),两组间差异无统计学意义(P=0.654)。病例组无瘤缓解期(64.00±33.20)月,对照组(49.38±36.97)月,两组间差异无统计学意义(P=0.346)。多因素Cox回归模型分析,HRT不是患者术后复发的独立危险因素(P=0.338)。结论对于Ⅰ期子宫内膜癌患者术后行HRT未增加肿瘤的复发率。 相似文献
20.
Background Adenocarcinoma of the small bowel is relatively less common than malignancies of the esophagus, stomach, and colorectum. In
small bowel adenocarcinoma, various prognostic factors influence the disease-free status and overall survival rates.
Materials and Methods Eighty patients who were diagnosed with small bowel adenocarcinoma and treated at our institute between 1983 and 2003 were
retrospectively reviewed.
Results The patients included 40 men and 40 women with an age range of 15 to 93 years (median: 62 years). Only 51.3% of patients were
accurately proved preoperatively to have a malignancy by endoscopic biopsy. Sixty patients underwent surgical treatment, and
45 of those patients had curative resection. The follow-up period ranged from 2.5 to 229.7 months, with a median of 9.1 months.
The cumulative 1-, 3-, and 5-year survival rates for all patients (excluding 3 patients who died in the immediate postoperative
period) were 43.6%, 22.8%, and 17.5%, respectively. The cumulative 1-, 3-, and 5-year disease-free survival rate for all 43
patients with curative resection (excluding 2 patients who died in the immediate postoperative period) was 54.9%, 30.5%, and
27.4%, respectively. Meanwhile, multivariate analysis with Cox proportional hazards analysis demonstrated that earlier tumor
stages (stages I and II) and curative resection were two independent factors influencing favorable overall survival. Lymph
node metastasis was the only independent factor predicting poor disease-free survival in patients undergoing curative resection.
Conclusions Poor prognosis of small bowel adenocarcinoma may be related to a delay in the diagnosis and treatment of the disease. Curative
resection is the aim of surgical treatment for small bowel adenocarcinoma. Lymph node metastasis at presentation of the disease
predicts tumor recurrence and distant metastasis after curative surgical treatment. 相似文献