1964例原发性支气管肺癌的外科手术经验

目的 总结１９６４例原发性支气管肺癌的外科手术经验,方法 对１９６４例肺癌患者（中心型１１４０例,周围型８２４例）的临床和病理资料进行回顾性分析。结果 全组手术切除共１６２６例,切除率为８２．８％,其中全肺切除１６０例,肺叶切除１３８６例,支气管袖状成形肺叶切除７０例及支气管楔形成形肺叶切除１０例。术后发生并发症２９４例,死亡２０例,手术死亡率为１．０％（２０／１９６４）,对手术中常见的疑难病例处理进行了分析。结论 手术为肺癌的主要治疗方式之一。若遇左上肺产吕浸润和包绕左肺动脉干,应先阻断动脉根部,再分离被浸润的土叶肺动、静脉并予结扎切断,然后切除有肿瘤的左上叶,最后清除血管壁上残余的癌组织,中晚期中心型肺癌以及肺动,静脉根部距肿瘤距离太短（≤０．５ｃｍ）的病例应行心包内结扎肺血管。右上肺癌浸润和包绕上腔静脉和

The experience of surgical resection in 1964 cases of primary bronchogenic carcinoma

Objective To summarize the experience of surgical resection of primary bronchogenic carcinoma (PBC). Methods We reviewed the clinicopathologic data of 1?964 cases of PBC. There were 1?140 central type and 824 peripheral type. Results Among them, 1?626 cases (82.8%, 1?626/1?964) were given successive resection, in which 160 cases were total pneumonectomy, 1?386 cases were lobectomy, 70 cases were sleeve lobectomy, and 10 cases were wedge resection. Two hundred and ninety four cases had various postoperative complications and 20 cases died. The operative mortality was 1.0%(20/1?964). Managements of problems encountered in operation were discussed in this paper.Conclusion Surgical resection is a better apporach in the treatment of PBC. Left upper lung cancer invading and surrounding the pulmonary artery trunk requires blocking the pulmonary artery root first, then separating the invaded blood vessels and resecting the tumor and upper pulmonary lobe, lastly dealing with the remained cancer tissues. For patients with intermediate and advanced lung cancer, if the root of pulmonary artery and vein almost attaches to the tumor, intrapericardial blood vessels ligation should be performed. When the right upper lung cancer invades and surrounds the superior vena cava and the upper pulmonary artery trunk, we should cut and ligate the azygos vein first and draw the superior vena cava gently towards front outside and dissect carefully. If the tumor, hilar, mediastinal and associated lymph nodes mix together to form the frozen hilar, we should deal with the main bronchus first, then the pulmonary artery and vein.