Ventsiavichius V, Tsitsenas S, Tikuĭshis R
Probl Tuberk Bolezn Legk. 2007(5):32-6.
The paper deals with the important problem of pulmonary surgery--the capacities of surgical treatment in concomitance of pulmonary tuberculosis and lung cancer. In 1990 to 2002, the Santarishkes Republican Tuberculosis and Lung Diseases Hospital and the Department of Thoracic Surgery and Oncology, Vilnius University Cancer Institute operated on 2218 patients with lung cancer, of them 46 (2.1%) were diagnosed as having concomitance of lung cancer and tuberculosis. The diagnosis of central and peripheral lung cancer was established in 37 (80.4%) and 9 (19.6%) patients, respectively. Histology revealed squamous-cell tumors in 24 (52.2%) patients, adenocarcinoma in 10 (21.7%), and adenosquamous-cell carcinomas in 12 (26.1%) patients. Stages I, II, and III were established in 12 (26.1%), 11 (23.9%), and 23 (50%) patients, respectively. Pulmonectomy was performed in 18 (39.2%) patients; 10 (21.7%), 10 (21.7%), and 8 (17.4%) patients underwent lobectomy, bilobectomy, and segmentectomy, respectively. Postoperative complications were observed in 28 (60.8%) patients. There were 6 (13%) cases of death. Twenty-three (50%) patients received complex treatment. Surgery is the method of choice in the treatment of concomitance of pulmonary tuberculosis and lung cancer. In such patients, survival averaged 28 +/- 2 months.
本文探讨了肺外科的一个重要问题——肺结核与肺癌并存时的外科治疗能力。1990年至2002年,桑塔里什克斯共和国结核病和肺病医院以及维尔纽斯大学癌症研究所胸外科和肿瘤科对2218例肺癌患者进行了手术,其中46例(2.1%)被诊断为肺癌与肺结核并存。分别在37例(80.4%)和9例(19.6%)患者中确诊为中央型和周围型肺癌。组织学检查显示,24例(52.2%)患者为鳞状细胞肿瘤,10例(21.7%)为腺癌,12例(26.1%)为腺鳞癌。分别有12例(26.1%)、11例(23.9%)和23例(50%)患者为Ⅰ期、Ⅱ期和Ⅲ期。18例(39.2%)患者接受了肺切除术;分别有10例(21.7%)、10例(21.7%)和8例(17.4%)患者接受了肺叶切除术、双肺叶切除术和肺段切除术。28例(60.8%)患者出现术后并发症。有6例(13%)死亡。23例(50%)患者接受了综合治疗。手术是治疗肺结核与肺癌并存的首选方法。此类患者的平均生存期为28±2个月。