肺癌全肺切除124例治疗总结

１９８２．１０～１９９１．１２我们行全肺切除术治疗肺癌１２４例，占同期肺癌外科治疗的１５．１％。其中心包内处理血管８８例，占７１％。手术死亡率０．８％。术后并发症３．２％，无支气管胸膜瘘发生。术后５年生存率为２７．７％，其中非小细胞癌５年生存率３５．１％，未分化小细胞癌无１例生存满５年者。晚期肺癌心包内处理血管是安全的，能提高手术切除率。对ＩＩＩ期未分化小细胞癌是否施行全肺切除，提出探讨。

Clinical Results of 124 Cases of Lung Cancers Undergoing Pneumonectomy

From October 1982 to December,1991 124 cases of lung cancers were treated by pneumonectomy.The number of patients amounted to 15.1% of the operated patients with lung cancers during the same period of time. Among the 124 patients,the intrapericardial pulmonary vessels(IPPVs)were handled intrapericardially in 88.Three different techniques were employed. When the IPPVs were long enough,double ligations or transfixed ligations with transections were done(68 cases,77.35);When IPPVs were too short to be simply ligated the IPPVs were cross clamped near the atrial wall and were closed with continuous sutures before transection(14 cases,15.9%);when the cancer already invade the roots of the pulmonary vessels or the adjacent atrial wall,a partial atrial resection was chosen(6 cases,6.8%).Both pathological and clinical situation of different period were analyzed. The operative mortality rate was 0.8% and the postoperative complications were 3.2%.No bronchopleural fistula occurred.The overall 5 year survival rate was 27.7%.It was 35.1% and zero in 95 cases of NSCLC and 27 cases of SCLC respectively...The authors considcred that in late cases of lung cancers it is quite safe to perform a pneumonectomy by handling the pulmorary vessels intrapericardially. This technic can also raise the successful resection rate. The authors discussed the possibility of pnemonectomy in case of one sided SCLC of stage III.