气管隆突切除及重建术治疗中心型支气管肺癌

本文报告１０例侵及气管隆突或距隆突０．３ｃｍ以内的中心型支气管肺癌行气管隆突切除及重建术，其中右上叶及隆突切除重建术３例，右全肺及隆突切除２例，左全肺及隆突切除４例，左上叶及隆突切除重建术１例，加部分左心房切除术３例。本组根治切除９例。姑息切除１例。术后并发症３例（３０％）。术后无癌生存６年１例，３年１例，２年１０月１例，２年６月３例，１年２例，半年１例；另１例于术后８月死于脑转移。重点讨论了手术适应证、手术方法、围手术期监护和处理。

Resection and Reconstruction of the Tracheal Carina in the Treatment of Central Type Bronchogenic Carcinoma

From March 1988 to september 1993, ten patients with bronchoganic careinoma underwent resection and reconstrution of the tracheal carina. The modes of operation were as follows: right upper lobectomy combined with reconstruction of the carina in 3 cases, right and left pneumonectomy with complete resection of the carina in 2 cases and 4 cases respectively, left upper lobectomy with reconstruction of the carina in 1 case, and with partial resection of left atrium in 3 cases . Nine patients had radical resection of the cancer, and one palliative. Three patieats had postoperative complications (39%). One patients survived for more than 6 years, 1 more than 3 years. 4 over 2 years and 6 months, 2 more than 1 year and another case more than 6 months without recurrence or metastasis of the cancer after operation.However, one patient dead 8 months after removal of the cancer because of brain metastasis of the tumor.In this paper, the indications, operative techniques, and peri-operative care and management of this procedure have been discussed.