解剖性肺切除治疗80岁以上老年人肺癌

 【摘要】　目的　探讨经不损伤肌肉切口行解剖性肺切除治疗80岁以上老年人肺癌的安全性和治疗效果。方法　对16例80岁以上肺癌患者进行外科治疗，均经腋下保留胸部肌肉和肋间神经的小切口完成解剖性肺切除加纵隔淋巴结清除手术。肺叶切除8例，双叶切除3例，支气管袖式肺叶切除2例，肺叶切除加楔形切除2例，全肺切除1例。结果　全组患者无围手术期死亡。术后9例患者入住外科监护室，时间平均为2.3 d；需机械通气者6例，机械通气时间3～18 h；前3位并发症分别为心律失常、肺部感染和低氧血症。全组患者平均住院时间为9 d，最短5 d，最长为14 d。结论　解剖性肺切除可被安全应用于部分80岁以上老年肺癌患者。

Major lung resection for the treatment of lung cancer in octogenarian patients

Objective To explore the clinical characteristics of bronchial carcinoma in elder patients and determine the operative indication, surgical technique, and management in the perioperative period. Methods 16 patients with bronchial carcinoma aged 80 and over received major pulmonary resection through muscle sparing mini-thoracotomy. The operative procedures were lobectomy(8 cases), bilobectomy (3 cases), sleeve lobectomy (2 cases), pneumonectomy (1 case), and lobectomy plus wedge resection (2 cases). Clinical data were analyzed retrospectively. Results Of the 16 patients, 6 with stage Ⅰ disease, 3 with stage Ⅱ and 7 with stage Ⅲdisease. There were no perioperative death occurred. The most popular postoperative complications were cardiac arrhythmia, pulmonary infection and hypoxemia. Conclusion Major pulmonary resection is a rational choice for part of the octogenarian patients with lung cancer.