AN EVALUATION OF VAR10US RESECTIONS IN THE SURGICAL TREATMENT OF LUNG CANCER

The indications and results of various resec- tions for lung cancer were evaluated, basing on the experience in 748 patients treated surgically from 1961 through 1982. Of this series there was an overall resectability rate of 80.3', a resection mortality rate of l.20l-f, and an overall 5.year survival rate of 42.0%. Regular lobectomy, currently the most common ly used or standard procedure for lung cancer was done in 445 (74.0%) cases, with an operative mor tality of l.1% and a 5-year survial rate of 42.2%. Ilronchoplastic lobectomy was performed in 67 (11.2%), with an operative mortality of l.5% and a 5-year survival rate of 54.1%. As a surgica'l pro ccdure for lung cancer it is highly evaluated. Pneu monectomy was done in only 74 (12.3%), with an operative mortality of l.4To and a 5.year survival rate of 35.3%, and was reserved almost exclusively for patients who have adequate cardiopulmonary function and in whom, for technical or oncologic reasons, radical eradication of the tumor could not be accomplished with a lesser extent of resection. Emphasis is made on the strict indications for each mode of resection, and on the principle of maximal cancer eradication and maximal conserva tion of functionall lung tissue.     

开胸术后呼吸功能衰竭

分析了３０例开胸术后呼衰的临床资料，结果表明此种呼衰无法预测。本组无死亡的关键在于该组病人肺储备功能较好，呼衰发现及时，并尽早应用了机械辅助通气等治疗措施。提出肺功能低下及术后合并肺部感染是造成长期依赖机械辅助通气的原因；并提出加强胸部物理治疗、合理应用抗生素以及尽早行气管切开是控制感染的有效方法。     

肺部炎性假瘤的外科治疗

肺部炎性假瘤是肺实质内一种炎性增生性病变,易与肺癌相混淆。本文报告31例肺部炎性假瘤,男14例,女17例,与同期肺支气管癌病例399例之比为1:12.87。患者年龄22～65岁,平均年龄50岁,其中40～50岁14例,占45.16％。术前与肺癌鉴别较困难。但本病发病年龄偏低、症状轻、病程长,与肺癌不同。手术中应做冰冻切片,对证实为本病者,尽量保留肺组织,做楔形、肺段切除或肺叶切除。     

自体气管移植的实验研究

研究了大网膜包裹分期气管移植法的可行性和有效性。将８只犬各自的一段颈部气管（６个软骨环）埋入大网膜内，１４日后，再将该段气管带大网膜蒂植入胸段气管中。实验犬全部长期存活。６个月后对移植气管行大体和组织学检查，见移植气管正常，无变形狭窄。表明该气管移植方式安全可行，并可避免自体移植气管发生缺血坏死。     

肺癌全肺切除术后脓胸并不提高术后生存率

文献上对肺癌全肺切除术后脓胸是否能提高术后生存率一直有争论。有些著者,特别是Takita及Ruckdesehel等认为肺癌全肺切除术后脓胸可提高术后生存率。1980年5月在法国胸部和心血管外科会议上集中讨论了肺癌全肺切除术后支气管瘘和脓胸,作者并     

食管——贲门粘膜撕裂症(综述)

本症系因呕吐或其他原因引起食管下段和胃贲门部粘膜撕裂,发生不同程度的出血。又称Mallory-Weiss综合征。由于对上消化道出血患者更多地作了急诊胃镜检查,本症的发现率近几年已有明显增     

肺癌的肺灌注显像特点及其临床应用

本文应用~(99m)TC-MAA为29例肺癌患者行肺灌注显像,采用改良的Moser给药方法。使用美国GE公司STARCAM400A/T SPECT显像及定量计算。比较肿瘤与灌注缺损大小,将肺灌注图     

原发性空洞性肺癌引起的自发性气胸

自发性气胸作为原发性肺癌的最初表现很少见,文献尚未见报道,本文报告2例。例1,51岁,女,右胸痛和气短3天。入院当天咯淡红色血致毫升。胸片示右肺全部萎陷。置胸管引流,5天后肺复张拔管。一周后胸片示右上叶薄壁空     

THE ROLE OF PNEUMONECTOMY IN LUNG CANCER ANALYSIS OF 63 CASES

Of the 504 resectiolns performed for lung cancer at our institute from 196.1 through 1981, 63 (12.5To) were pneumonectomies. Right pneu- monectomy was done in 17 and le,ft in 46 0.f the cases, for a right-to-le.ft ra.tio o.f 1:2.7. The relatively low percentage of pneumonectomy in this s.eries reflect.s: (1) the strict criteria for choosing this operat.ion (pneumonectomy was reserved almost exclusively for patients who had adequate cardiopulmonary funct.ion. and in whom, for technical or' oncologic reasons, radical eradication of the tumo:r could not oitherwise be achieved, pallia.tive pneumonectomy was. avoided whenever possible), and (2) the use of bronchoY plastic lobectomy, which const.ituted 11.3To o.f all resections and has largely replaced pneumonec- t.omy. Right pneumonectomy sho,uld be chosen even more caut.iously than left beca.use of the greater functional loss that result.s. The opera- tive mortality of only l.6TO (1/63) and the gratify- ing 5-year survival rate of 42.970 in this series imply that the criteria used in selecting patients for pneumonectomy were sound.     

肺癌外科治疗—20年576例经验

本文总结我院自1961至1980年近20年间对576例肺癌病人外科治疗的经验。其中包括1978年已发表的340例。 临床资料及结果 性别、年龄 男466例、女110例,男女之比为4.2:1。年龄自21至74岁,平均50岁;39岁以下者67例,占11.6％。 肿瘤大小 本组切除459例的肿瘤直径<3厘米者126例(27.5％),3—5厘米者238例(51.9％),>5厘米者94例(20.5％),1例无记录(0.2％),直径在3—5厘米者占约半数。不能切除的117例,直径多在5厘米以上。