支气管成形术治疗肺癌20例

目的探讨支气管成形术治疗肺癌的适应证、手术方法及注意事项。方法 2000年1月—2010年12月应用支气管成形术治疗肺癌20例,其中男15例,女5例;年龄48～75岁,平均62岁;左肺上叶支气管袖状切除5例;右肺上叶支气管袖状切除8例;右肺上中叶支气管袖状切除3例;左肺上叶支气管及左肺动脉双袖状切除2例;右肺上叶支气管袖状及右肺动脉侧壁切除成形2例。术后病理诊断:鳞癌14例,腺癌3例,小细胞癌2例,腺样囊性癌1例。结果无手术死亡,未发生支气管胸膜瘘、大咯血、脓胸等其他严重并发症。结论支气管成形术已成为治疗中心型肺癌的首选术式,但必须严格掌握其适应证、熟练掌握操作方法及注重术后处理。

Therapy for 20 cases of lung cancer with bronchoplasty

Objective To sum up the clinical experience in bronchoplasty for therapy of 20 cases of lung cancer,in order to explore the operative indications,approaches,attentions and postoperative treatment. Methods Bronchoplasty were applied to 20 patients with lung cancer(15 males,5 females),aging from 48-75 years(mean=62 years),from Jan.2000 to Dec.2010.Sleeve resection of bronchus was performed at upper lobe of left lung in 5,at upper lobe of right lung in 8,and at upper-mid lobe of right lung in 3 cases;double-sleeve resection of bronchus of upper lobe and pulmonary artery was done at left lung in 2 ones;sleeve resection of bronchus of upper lobe and pulmonary artery wall resection plus plasty at right lung in 2 ones.Postoperative pathological diagnosis included squamous carcinoma(n=14),adenocarcinoma(n=3),small cell carcinoma(n=2),adenoid cystic carcinoma(n=1). Results Neither death nor sever complications,such as bronchopleural fistula,hemoptysis and pyothorax,occurred during and after operation. Conclusion Bronchoplasty is an advanced operative approach for the therapy of central lung cancer.Doctors should strictly pay attention to operative indications,approaches and postoperative treatment.