原发性气管及隆突肿瘤的外科治疗

目的:总结和探讨原发性气管、隆突肿瘤外科治疗经验及治疗效果。方法:回顾性分析2007年1月2011年9月收治的23例行外科治疗的气管及隆突原发性肿瘤患者的临床资料,总结外科治疗方法及效果。结果:20例行气管环形切除加端-端吻合术,1例行袖式右全肺切除术(左主支气管气管端端吻合),2例行隆突切除及气管与支气管吻合重建隆突。体外循环辅助3例。术后病理示腺样囊性癌15例,黏液表皮样癌6例,鳞状细胞癌2例。气管切缘均未见肿瘤残存。全组患者均无围术期死亡,手术并发症5例。术后随访6个月-5年,死亡1例(4.3%),生存至今22例(95.7%),生存者均无肿瘤复发。结论:手术切除是治疗气管及隆突肿瘤的有效方法,病理类型及切除范围对患者术后远期生存率有很大影响,合理应用体外循环技术可提高手术安全性。

Surgical Treatment of the Primary Tracheal and Carinal Tumors

Objective:To summarize and explore the surgical experience and efficacy of primary tracheal and carinal tumors treatment.Methods:The clinical data of 23 patients with tracheal and carinal tumor underwent surgical treatment from January 2007 to September 2011 were retrospectively reviewed,and their surgical treatment and efficacy were summarized.Results:Resection and reconstruction of trachea were performed in 20 patients,right sleeve pneumonectomy combined with partial resection in 1 patient,and carinal resection and reconstruction in 2 patients.The operation of 3 cases was assisted by cardiopulmonary bypass.Postoperative pathological examinations showed 15 adenoid cystic carcinomas,6 mucoepidermoid carcinomas,and 2 squamous cell carcinomas.All surgical margins were negative.There was no death during perioperative period, while operative complications were found in 5 cases.The follow up time ranged from 6 months to 5 years,as 1 case died(4.3%) and 22 cases(95.7%) survived and without tumor recurrence. Conclusion;Surgical resection is effective to treat tracheal and carinal tumors,pathological type and excision extension have impacts on long term survival rate,and surgical safety can be improved with the proper assistance by cardiopulmonary bypass.