侵犯左心房的局部晚期非小细胞肺癌的外科治疗

目的 探讨侵犯左心房的局部晚期非小细胞肺癌的手术适应证、手术方式及术后处理。方法 回顾分析46例侵犯左心房的局部晚期非小细胞肺癌，其中40例在非体外循环下行左心房部分切除，另6例左心房受累范围广泛患者在体外循环支持下行左心房部分切除重建术；动脉插管部位分别为股动脉、降主动脉或升主动脉，静脉插管部位分别为肺动脉或上下腔静脉。结果 1例早期死亡于呼吸衰竭。1例急性肺水肿和3例心律失常均经保守治疗成功。1年、3年生存率分别为78．9％、43．0％。结论 体外或非体外循环方法均能安全有效地完成侵犯左心房的晚期肺癌的根治性切除，长期生存率尚需进一步观察。

Surgical treatment of locally advanced NSCLC invading left atrium

Objective To investigate the indication and operation way and post-operation regulation of locally advanced NSCLC invading left atrium. Methods Forty-six patients undergoing lung resection and partial resection of the left atrium was reviewed. Operations were performed under off- CPB in 40 patients. Other 6 patients with extensive atrial infiltration underwent surgery under CPB. The aortic and venous cannula were placed in the femoral artery or descending aorta or ascending aorta and pulmonary artery or superior and inferior vena cava. Results One died early for respiratory failure. Four had operative complication, including one acute pulmonary edema and three arrhythmia. The 1,3-year survival rates were 78. 9%, 43. 0% respectively. Conclusion This study confirms the safety of CPB and off-CPB for locally advanced NSCLC invading left atrium in well-selected patients. Further studies, however, are required to confirm long-term survival.