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[原发性肺癌的姑息性肺切除术]

[Palliative pulmonary resection for primary lung cancer].

作者信息

Ding J A

机构信息

Shanghai 1st hospital of Tuberculosis and Lung Tumor.

出版信息

Zhonghua Wai Ke Za Zhi. 1990 May;28(5):263-4, 316.

PMID:1707781
Abstract

From January 1961 through December 1984, 253 of 2048 patients who have undergone surgical treatment for primary lung cancer were retreated by palliative pulmonary resection. The indications of palliative resection were: there was partial carcinoma or metastatic lymph node left in the thorax; microscopically, residual tumor was found on bronchial stump margin. Operation modes: partial pulmonary resection 135, total pneumonectomy 118. Postoperative complications occurred in 25 cases and 17 died in the hospital with in 30 days. 236 cases were followed-up for 1 to 21 years. The 1-year, 3-year and 5-year survival rates after operation were 51.3%, 13.1% and 8.1% respectively. The survival rates after palliative pulmonary resection for squamous and adenocarcinoma were higher than thoracotomy but the survival rates of large undifferentiated, small cell and mixed cancer were similar to those of thoracotomy. Besides, patients who had both subcarinal lymph node involvement and incomplete excision in resection had the worst prognosis. The authors consider that squamous and adeno carcinoma of the lung are the main indication for palliative resection. Subcarinal lymph nodes must be excised as much as possible while operation, otherwise local radiation and/or chemotherapy should be performed after operation.

摘要

从1961年1月至1984年12月,2048例接受原发性肺癌手术治疗的患者中有253例接受了姑息性肺切除术。姑息性切除的指征为:胸腔内留有部分癌组织或转移淋巴结;显微镜检查发现支气管残端边缘有残留肿瘤。手术方式:肺部分切除术135例,全肺切除术118例。术后发生并发症25例,30天内17例死于医院。236例患者随访1至21年。术后1年、3年和5年生存率分别为51.3%、13.1%和8.1%。肺鳞状细胞癌和腺癌姑息性肺切除术后的生存率高于开胸手术,但大细胞未分化癌、小细胞癌和混合癌的生存率与开胸手术相似。此外,隆突下淋巴结受累且切除不完全的患者预后最差。作者认为,肺鳞状细胞癌和腺癌是姑息性切除的主要指征。手术时应尽可能切除隆突下淋巴结,否则术后应进行局部放疗和/或化疗。

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