Schinkel C, Mueller C, Reinmiedl J, Fuerst H
Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
J Cardiovasc Surg (Torino). 2000 Aug;41(4):637-40.
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.
Morbidity, mortality, and survival rate were investigated in these patients to verify the safety of this technique.
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.
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.
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。
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。
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。
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。