隆凸、支气管及肺动脉切除重建术治疗中心型肺癌

背景与目的 为了最大限度地保留健康肺组织，提高中心型肺癌患者的手术切除率和术后生活质量，气管隆凸、支气管及肺动脉成形术在国内外得到了广泛的应用。并取得了良好的治疗效果。本研究的目的是总结采用隆凸、支气管及肺动脉切除重建术治疗79例中心型肺癌的临床资料，分析其疗效。方法1988年6月至2005年6月，对79例中心型肺癌患者施行隆凸、支气管及肺动脉切除重建术。支气管环状切除成形及支气管袖状成形肺叶切除术58例；支气管肺动脉双袖状成形肺叶切除术15例；气管隆凸切除重建合并肺叶切除术6例。结果 本组无手术死亡病例。7例患者术后出现并发症，发生率为8．86％。术后1、3、5和10年生存率分别为78．5％、59．5％、35．4％和17．7％。结论 隆凸、支气管及肺动脉切除重建术能最大限度地保护肺功能，提高了中心型肺癌的治愈率和远期生存率。

Tracheo-carinal reconstruction, bronchoplasty and vascular reconstruction in the treatment of central lung cancer

Background and Objective To maximize the preservation of functional pulmonary parenchyma, extend the indication of lung cancer operation and improve the life quality of patients with central lung cancer, reconstruction of carina, bronchoplasty and arterioplasty are widely used with good efficacy. The aim of this study is to summarize the clinical results of reconstruction of carina, bronchoplasty and arterioplasty in the treatment of 79 patients with central lung cancer. Methods From June, 1988 to June, 2005, reconstruction of carina, bronchoplasty and arterioplasty were carried out in 79 patients with central lung cancer. The ope- rations included single sleeve lobectomy in 58 cases, double sleeve lobectomy in 15 cases, carinal resection and reconstruction in 6 cases. Results There was no operative death in this series. Seven patients had operative complications and the operative complication rate was 8.86% (7/79). The 1-, 3-, 5- and 10-year survival rates were 78.5%, 59.5%, 35.4% and 17.7% respectively. Conclusion Reconstruction of carina, bronchoplasty and arterioplasty can significantly protect pulmonary function, improve the prognosis and increase the curative rate and long term survival in patients with central lung cancer.