Takeda Shin-Ichi, Hashimoto Taikichi, Kusu Takashi, Kawamura Tomohiro, Nojiri Takashi, Funakoshi Yasunobu, Kadota Yoshihisa, Maeda Hajime
Department of General Thoracic Surgery, Toneyama National Hospital, Toneyama 5-1-1, Toyonaka City, Osaka 560-8552, Japan.
Interact Cardiovasc Thorac Surg. 2007 Aug;6(4):484-9. doi: 10.1510/icvts.2007.152280. Epub 2007 May 14.
We reviewed the records of 12 patients with primary tracheobronchial tumors and various clinical characteristics treated at our institution to investigate our overall management experience with disease. Over a 21-year period, we treated 1405 cases of primary pulmonary neoplasms, of which 12 (0.9%) patients had primary tracheobronchial tumors with eight different histological types, including three adenoid cystic carcinomas, two bronchial carcinoids, two papillomas, one squamous cell carcinoma, one mucous gland adenoma, one inflammatory pseudotumor, one schwannoma, and one mucoepidermoid carcinoma. Eleven of the patients had symptoms of airway obstruction and/or secondary infection or bleeding. A complete resection was performed in ten, which included a sleeve lobectomy in seven, sleeve pneumonectomy in one, tracheal resection in one, and left main stem resection without lung resection in one. Median survival following complete resection was 91 months. When possible, a complete resection provides the best potential benefits and symptomatic relief for patients with tracheo-endobronchial tumors. Further, various options related to tracheobronchoplasty including conservative resection can be applied for surgical intervention.
我们回顾了在我院接受治疗的12例具有不同临床特征的原发性气管支气管肿瘤患者的病历,以研究我们对该疾病的整体管理经验。在21年的时间里,我们共治疗了1405例原发性肺肿瘤患者,其中12例(0.9%)患有原发性气管支气管肿瘤,有8种不同的组织学类型,包括3例腺样囊性癌、2例支气管类癌、2例乳头状瘤、1例鳞状细胞癌、1例黏液性腺瘤、1例炎性假瘤、1例神经鞘瘤和1例黏液表皮样癌。11例患者有气道阻塞和/或继发感染或出血的症状。10例患者进行了根治性切除,其中7例行袖状肺叶切除术,1例行袖状全肺切除术,1例行气管切除术,1例行左主支气管切除术但未行肺切除术。根治性切除后的中位生存期为91个月。对于气管支气管内肿瘤患者,尽可能进行根治性切除可提供最佳的潜在益处和症状缓解。此外,包括保守切除在内的各种气管支气管成形术相关选择可用于手术干预。