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[双侧多发性肺癌的外科治疗]

[Surgical treatment for bilateral multiple lung cancers].

作者信息

Matsuge S, Hosokawa Y, Satoh K, Murakami Y, Yamakawa T, Hatakeyama H, Ishigooka M, Yamazaki S

机构信息

Department of Surgery, Kin-ikyou Chyuou Hospital, Sapporo, Japan.

出版信息

Kyobu Geka. 2000 Feb;53(2):89-94; discussion 94-6.

Abstract

We reviewed 12 patients with contralateral bronchogenic carcinomas. Seven of them had metachoronous carcinomas and 5 had synchronous carcinomas. We treated 3 patients with lobectomy on both lungs, and 4 patients with lobectomy and segmentectomy, 2 patients with lobectomy and wedge resection, 2 patients with segmentectomy and thoracoscopic wedge resection, and one patient with lobectomy and ablation on each lung. Two patients who had lobectomy on both lungs were dead, one of whom of bronchofistula on operation and the other of respiratory failure 7 years and one month after second operation. The 5-year survival rate in 12 patients was 68.5% after first operation and 82.5% after second operation. We conclude that lobectomy on both lungs are not recommended because of high mortality rate and the limited resection should be considered to treat the other contralateral primary lung cancers. Because the patients with primary lung cancers have the possibility to suffer from new primary cancers in the different site of the lung, we need careful follow up of the patients after treatment on the first lung cancer.

摘要

我们回顾了12例对侧支气管源性癌患者。其中7例为异时性癌,5例为同时性癌。我们对3例患者进行了双肺叶切除术,4例患者进行了叶切除术和段切除术,2例患者进行了叶切除术和楔形切除术,2例患者进行了段切除术和胸腔镜楔形切除术,1例患者进行了双肺叶切除术和消融术。2例接受双肺叶切除术的患者死亡,其中1例死于手术中支气管瘘,另1例死于第二次手术后7年零1个月的呼吸衰竭。12例患者首次手术后5年生存率为68.5%,第二次手术后为82.5%。我们得出结论,由于死亡率高,不建议进行双肺叶切除术,对于其他对侧原发性肺癌应考虑进行有限切除。由于原发性肺癌患者有可能在肺部不同部位患新发原发性癌症,因此在对第一例肺癌进行治疗后,我们需要对患者进行仔细随访。

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