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非小细胞肺癌支气管成形术后的发病率与生存率

Morbidity and survival after bronchoplastic surgery for non-small-cell lung cancer.

作者信息

Schinkel C, Mueller C, Reinmiedl J, Fuerst H

机构信息

Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.

出版信息

J Cardiovasc Surg (Torino). 2000 Aug;41(4):637-40.

Abstract

BACKGROUND

Bronchoplastic procedures are an accepted surgical approach in patients with resectable non-small-cell lung cancer (NSCLC) to avoid pneumonectomy. Post-operative complications associated with the bronchial anastomosis and local recurrence of the tumor have to be considered. Experimental design and setting: Retrospective analysis of the clinical courses and follow-up of 1,610 consecutive patients who received surgical resection for NSCLC at the Department of Surgery, Klinikum Grosshadern, University of Munich, Germany. Among them there were 134 (8.3%) bronchoplastic resections.

METHODS

Morbidity, mortality, and survival rate were investigated in these patients to verify the safety of this technique.

RESULTS

From all 134 bronchoplastic resections, 105 lobectomies, 22 bilobectomies, and 7 pneumonectumies were performed. Atelectasis was observed in 6.0% (versus conventional procedures: 3.7%; p: n.s.), whereas anastomotic dehiscence occurred in 3.0%. In-hospital mortality amounted to 3.7% (versus 5.3%; p: n.s.). The stage dependent 5-year survival in R0-resected patients was comparable in both groups.

CONCLUSIONS

Our results demonstrate that bronchoplastic procedures represent a safe therapeutic option in the operative treatment of non-small-cell lung cancer that should be considered in all patients with central tumor growth.

摘要

背景

支气管成形术是可切除的非小细胞肺癌(NSCLC)患者为避免肺切除术而被接受的手术方法。必须考虑与支气管吻合相关的术后并发症以及肿瘤的局部复发。实验设计与背景:对德国慕尼黑大学格罗斯哈德恩临床医院外科连续1610例接受NSCLC手术切除患者的临床病程和随访情况进行回顾性分析。其中有134例(8.3%)进行了支气管成形术切除。

方法

对这些患者的发病率、死亡率和生存率进行调查,以验证该技术的安全性。

结果

在所有134例支气管成形术切除中,进行了105例肺叶切除术、22例双肺叶切除术和7例全肺切除术。肺不张的发生率为6.0%(传统手术为3.7%;p:无统计学意义),而吻合口裂开的发生率为3.0%。住院死亡率为3.7%(传统手术为5.3%;p:无统计学意义)。两组R0切除患者的分期依赖性5年生存率相当。

结论

我们的结果表明,支气管成形术是NSCLC手术治疗中的一种安全治疗选择,所有中央型肿瘤生长的患者都应考虑采用。

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