气管隆凸主支气管肿瘤的外科治疗

目的 总结气管、隆凸主支气管肿瘤手术治疗经验,探讨合理的手术方法及治疗措施。方法 回顾性分析我院在1996年1月至2004年6月期间,手术治疗的27例气管、隆凸主支气管肿瘤患者的临床资料。27例中,鳞癌15例,腺癌3例,其余9例为良性腺瘤、腺样囊腺癌和类癌。结果 气管肿瘤切除＋端端吻合8例;全肺隆凸切除＋气管与主支气管端端吻合9例（右6例,左3例）;右上肺隆凸袖式切除重建术2例;隆凸切除重建术3例;气管肿瘤及气管壁部分切除5例,其中体外循环辅助下手术2例。术后早期死亡3例,其中2例死于多器官衰竭,1例系因胸腔感染、出血死亡。半年以上随访24例,无死亡,无外科并发症。结论 隆凸及气管手术比较复杂,难度大,应选择合理的术式及麻醉方法,必要时应用体外循环辅助,可以取得满意疗效。

Surgical treatment for tumors of trachea, carina and main bronchus

Objective To review the experience in surgical treatment for tumors of trachea,carina and main bronchus.Methods From Jan.1996 to Jun.2004,27 patients with tumor of trachea,carina or main bronchus underwent surgery including resection and reconstruction of trachea in 8,right/left pneumonectomy and carinal resection and reconstruction in 9(6/3),right sleeve upper lobectomy and carnial resection with reconstruction of trachea and carina in 2,carina resection and reconstruction in 3, tumor removal through tracheal windows in 5.CPB(eardiopulmonary bypass)was used in 2 patients during surgery.Results There were 3 peri-operative deaths caused by acute respiratory failure in 2 and severe postoperative bleeding in 1 case.After follow-up of more than 6 months,no death or post-operative complication occurred.Conclusion Resection and reconstruction for patients with tumor of trachea,main bronchus or carina can be performed with excellent results using effective surgical and anaesthetic methods with or without CPB assistance.