Dujon A
C.M.C. du Cèdre, Bois-Guillaume, Rouen.
Rev Pneumol Clin. 1992;48(5):217-23.
Lung cancer resection surgery often reduces the respiratory function to the point that it can preclude pneumonectomy or even standard lobectomy. When these usual operations are impossible for functional reasons more restricted procedures can be performed, local conditions permitting. Thus, lobectomy with resection anastomosis may be a suitable alternative to pneumonectomy, and segmental resection may be considered when standard lobectomy is rejected. However, this conservative surgery can be envisaged only when it does not risk to affect the quality of the long-term results. While lobectomy enlarged to the bronchial tree has proved to be justified for the treatment of cancers without lymph node invasion, limited resections give uncertain results and must be regarded as an alternative to surgical abstention.
肺癌切除手术常常会使呼吸功能降低到无法进行全肺切除术甚至标准肺叶切除术的程度。当由于功能原因无法进行这些常规手术时，在局部条件允许的情况下，可以实施更为受限的手术。因此，对于全肺切除术而言，带切除吻合术的肺叶切除术可能是一种合适的替代方案，而当标准肺叶切除术不可行时，可以考虑进行肺段切除术。然而，只有在不影响长期疗效质量的情况下，才可以考虑这种保守手术。虽然扩大到支气管树的肺叶切除术已被证明对于治疗无淋巴结转移的癌症是合理的，但有限切除的结果不确定，必须被视为手术放弃的一种替代方案。
