Wu Mingbai, Zhang Zhu, Zhang Liwei, Zhang Changming, Zhu Hui
Department of Thoracic Surgery, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang 830000, P.R.China.
Zhongguo Fei Ai Za Zhi. 2005 Feb 20;8(1):42-4. doi: 10.3779/j.issn.1009-3419.2005.01.09.
Reconstruction of carina, bronchoplasty and arterioplasty are widely used to extend the indication of lung cancer operation. Because these procedures preserve as many healthy lung tissues as possible, their therapeutic effect is better than pneumonectomy in many central lung cancer cases with poor cardiopulmonary function. The aim of this study is to explore the feasibility and indication of extended resection in selected patients with centrally located lung cancer.
From November, 1979 to January, 2003, lobectomy or pneumonectomy combined with extended resection of tracheo-carina, bronchus or vessels were performed in 50 patients with centrally located lung cancer. Tracheo-carinal reconstruction and bronchoplasty were performed in 48 cases, and pulmonary arterioplasty in 2 cases.
Postoperative complications occurred in 4 patients (8.0%), and operative death occurred in 2 patients (4.0%). All the 48 patients were followed up from 1 to 10 years. The 1-, 3-, 5- and 10-year survival rate was 89.4% (42/47), 57.1% (20/35), 42.1% (8/19) and 25.0%(2/8) respectively.
Extended pulmonary resection combined with tracheo-carinal reconstruction, bronchoplasty and vascular reconstruction is feasible for selected patients with centrally located lung cancer. It is helpful to prolong the long-term survival of patients with lung cancer.
隆突重建、支气管成形术和血管成形术广泛应用于扩大肺癌手术的适应证。由于这些手术能尽可能多地保留健康肺组织，在许多心肺功能较差的中央型肺癌病例中，其治疗效果优于肺切除术。本研究的目的是探讨对部分中央型肺癌患者进行扩大切除术的可行性和适应证。
1979年11月至2003年1月，对50例中央型肺癌患者行肺叶切除术或肺切除术并联合气管隆突、支气管或血管的扩大切除。48例行气管隆突重建和支气管成形术，2例行肺动脉成形术。
4例（8.0%）发生术后并发症，2例（4.0%）发生手术死亡。48例患者均获随访1至10年。1年、3年、5年和10年生存率分别为89.4%（42/47）、57.1%（20/35）、42.1%（8/19）和25.0%（2/8）。
对部分中央型肺癌患者行扩大肺切除术并联合气管隆突重建、支气管成形术和血管重建是可行的。有助于延长肺癌患者的长期生存。
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