Liu Zhidong, Xu Shaofa, Qin Ming, Zhao Liqiang, Li Fugen, Duan Yong, Liang Zikun
Department of Thoracic Surgery, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, P.R.China.
Zhongguo Fei Ai Za Zhi. 2004 Oct 20;7(5):434-7. doi: 10.3779/j.issn.1009-3419.2004.05.14.
To summarize the operative indication, surgical technique and perioperative ma-nagement of resection and reconstruction of carina for advanced lung cancer involving the carina.
There were 67 patients with lung cancer invaded the carina, right central lung cancer in 46 cases, peripheral lung cancer in 4 cases, involved superior vena cava (SVC) or with bilateral anonymous veins in 11 cases, left central lung cancer in 17 cases, respectively. Surgical procedure included carinal right pneumonectomy or lobectomy in 50 cases, concomitant replacement of SVC or with bilateral anonymous veins with vascular prosthesis in 11 cases, carinal left pneumonectomy in 17 cases. Follow-up was performed in long-term.
Perioperative death occured in 8 cases (11.94%), circulatory failure in 6 cases (8.96%), and respiratory failure in 2 cases (2.99%). The overall 1-, 3- and 5-survival rate was 77.21%, 48.23% and 32.54% respectively.
Complete resection and reconstruction of carina, SVC or bilateral anonymous veins combined with postoperatively multiple modality therapy can get good prognosis for the patients with advanced lung cancer.
总结侵犯隆突的晚期肺癌隆突切除重建的手术适应证、手术技术及围手术期管理。
67例肺癌侵犯隆突患者,其中右肺中央型肺癌46例,周围型肺癌4例,侵犯上腔静脉或双侧无名静脉11例,左肺中央型肺癌17例。手术方式包括隆突右全肺切除术或肺叶切除术50例,11例同时行上腔静脉或双侧无名静脉血管置换术,隆突左全肺切除术17例。进行长期随访。
围手术期死亡8例(11.94%),其中循环衰竭6例(8.96%),呼吸衰竭2例(2.99%)。1年、3年和5年总生存率分别为77.21%、48.23%和32.54%。
隆突、上腔静脉或双侧无名静脉的完整切除重建并联合术后多模式治疗可使晚期肺癌患者获得良好预后。