Zhang Peng, Chen Gang, Liu Yimei, Han Fen
Department of Cardiothoracic Surgery, General Hospital, Tianjin Medical University, Tianjin 300052, P.R.China.
Zhongguo Fei Ai Za Zhi. 2006 Feb 20;9(1):25-7. doi: 10.3779/j.issn.1009-3419.2006.01.07.
The extent of pulmonary resection is decided by the location and extent of the tumor and the patient's physiologic ability to tolerate resection. Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy. In this article our experience with arterioplastic and bronchoplastic procedures in the treatment of central-type bronchogenic carcinoma was reviewed.
From October 1999 to October 2005, 12 pulmonary arterioplasties and 14 combined broncho-angioplasties were performed for bronchogenic carcinoma and meanwhile two replacement of vena cava were done.
Of the 26 patients, 18 were in stage II and 8 were in stage III. No fatal surgical complications occured. Atelectasis occurred in 2 patients (7.7%), postoperative pneumonitis in 2 (7.7%), and reperfusion lung injury in one (3.8%). The 1-and 3-year survival rates for the entire group were 100.0% and 69.2% respectively.
Pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Angioplastic and combined broncho-angioplastic procedures offer patients with bronchogenic carcinoma similar a long-term result as radical lung resection, especially in patients who cannot tolerate pneumonectomy due to poor cardiopulmonary reserve.
肺切除术的范围取决于肿瘤的位置和范围以及患者耐受切除的生理能力。近年来,支气管成形术和肺动脉成形术作为肺切除术的替代方法越来越受欢迎。本文回顾了我们在治疗中央型支气管肺癌中进行动脉成形术和支气管成形术的经验。
1999年10月至2005年10月,对支气管肺癌患者进行了12例肺动脉成形术和14例联合支气管-血管成形术,同时进行了2例腔静脉置换术。
26例患者中,18例为Ⅱ期,8例为Ⅲ期。未发生致命的手术并发症。2例(7.7%)发生肺不张,2例(7.7%)发生术后肺炎,1例(3.8%)发生再灌注肺损伤。全组1年和3年生存率分别为100.0%和69.2%。
肺动脉成形术和支气管-血管成形术可安全进行。血管成形术和联合支气管-血管成形术为支气管肺癌患者提供了与根治性肺切除术相似的长期效果,尤其是对于因心肺储备功能差而不能耐受肺切除术的患者。