气管、支气管或(和)心血管成形术治疗中心型肺癌

目的 探讨中心型肺癌选择性进行扩大切除手术的可行性。方法 1987年1月～2001年12月对134例中心型肺癌施行肺叶或全肺切除同时行气管、支气管或(和)心血管成形手术。本组气管支气管成形术80例，心血管成形术54例(32例同时行支气管成形术)。结果 死亡1例，并发症16例(11．9％)。对2。00年12月以前手术124例中的117例进行了随访，随访率94．4％。气管、支气管成形术1、3、5年生存率分别为84．7％(61/72)、56.7％(34/60)、45．7％(21/46)；心血管成形术1、3、5年生存率分别为69．2％(36/52)、46．8％(22/47)和22．2％(8/36)。结论 侵及胸腔重要器官的中心型肺癌选择性地进行肺叶或全肺切除的同时进行气管、支气管或(和)心血管成形术是可行的，能延长患者的生存期。

Tracheo-bronchoplasty and/or cardiovascular reconstruction in the treatment of centrally located lung cancer

Objective To explore the feasibility of extended resection in selective patients with centrally located lung cancer. Methods From January, 1987 to December, 2001, lobectomy or pneumonectomy combined with extended resection of trachea, bronchus, heart or great vessels were carried out in 134 patients with centrally located lung cancer. The operations included bronchoplastic procedures in 80 cases, extended resection and reconstruction of left atrium and/or great vessels in 54 cases (32 cases with contemporary bronchoplasty). Results Operative death occurred in one case. Postoperative complications happened in 16 cases (11.9%). One hundred and seventeen cases (94.4%) were followed up. The 1 , 3 , 5 year survival rate was 84.7% (61/72), 56.7% (34/60) and 45.7% (21/46) respectively, while of those combined with tracheo bronchoplasty and/or cardiovascular reconstruction, the 1 , 3 , 5 year survival rate was 69.2% (36/52), 46.8% (22/47) and 22.2% (8/36) respectively. Conclusion Extended resection combined with tracheo bronchoplasty and/or cardiovascular reconstruction is feasible for selected patients with centrally located lung cancer and could improve the survival and life quality of patients.