支气管肺动脉成形术在中心型支气管肺癌治疗中的应用

目的]探讨支气管肺动脉成形术治疗中心型支气管肺癌的效果。方法]回顾性分析2001年6月～2009年6月施行支气管肺动脉联合成形肺叶切除治疗的36例中心型支气管肺癌患者的临床资料,其中鳞癌26例,腺癌8例,小细胞未分化癌2例。pTNM分期:Ⅱa期8例,Ⅱb期12例,Ⅲa期16例,行左上支气管肺动脉成形术14例,右上肺动脉支气管成形术22例。结果]全组无手术死亡病例,术后4例出现肺不张,4例并发肺感染,2例并发心律失常,均经对症、抗感染等处理后治愈,无支气管胸膜瘘、出血等严重并发症发生。术后随访时间5～65个月,平均32个月,全组术后1、3、5年生存率分别为88.9%(32/36)、55.6%(20/36)、44.4%(16/36)。结论]肺动脉支气管成形术肺叶切除符合最大限度地切除肿瘤又最大限度保留肺功能的基本原则,特别是用于心肺功能储备差、不能耐受全肺切除的局部晚期患者,扩大了手术适应证。

APPLICATION OF BRONCHIAL PULMONARY ARTERY ANGIOPLASTY IN THE CENTRALTYPE LUNG CANCER

Objective] To investigate the effect of bronchial pulmonary artery angioplasty for treatment of central lung cancer.Methods] To analyze retrospectively the data of 36 patients with central type lung cancer who suffered from implementation of the joint forming the bronchial pulmonary lobe resection from June 2001 to June 2009.Of 36 patients,including squamous cell carcinoma in 26 cases,adenocarcinoma in 8 cases,and small cell undifferentiated carcinoma in 2 cases.pTNM staging:Ⅱa period of 8 cases,Ⅱb period of 12 cases,Ⅲa period of 16 patients.The left bronchial pulmonary artery angioplasty were in 14 cases,right upper pulmonary bronchoplasty were in 22 cases.Results] There were no operative deaths,postoperative atelectasis in 4 cases,pulmonary infection in 4 cases,arrhythmia in 2 cases,and all patients were cured by symptomatic,anti-infection treatment.No bronchopleural fistula,bleeding and other serious complications occurred.Patients were followed up for 5 to 65 months with an average of 32 months,and the survival rates of the group after 3,5-year were 88.9%(32 /36),55.6%(20 /36),44.4%(16 /36).Conclusion] Pulmonary lobectomy in line with the bronchial angioplasty to remove the tumor can maximize remove the tumors and retain lung function,especially for poor cardiopulmonary reserve patients who can not tolerate pneumonectomy with locally advanced lung cancer.