Zhang Peng, Jiang Chao, He Wenxin, Song Nan, Zhou Xiao, Jiang Gening
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, Peoples Republic of China.
J Cardiothorac Surg. 2012 Oct 9;7:107. doi: 10.1186/1749-8090-7-107.
To analyze the experience of completion pneumonectomy for lung cancer at a single institution in China.
From January 1988 to December 2007, 92 patients underwent completion pneumonectomy for the treatment of lung cancer. The indications were second primary lung cancer (n=51), Local metastasis (n=37) and Lung metastasis (n=4). The median interval between the primary operation and CP was 24.4 months (1.5-145 m).
There was no intraoperative deaths. The CP procedure lasted 4.3 h (1.5-8 h). Blood loss in the CP performance was 1854.5 ml (200-9100 ml) 9 (9.78%) patients died in the postoperative period: pulmonary embolism (n = 2), disseminated intravascular coagulation (DIC) after the multisystem failure (n = 1), respiratory failure after contralateral pneumonia (n = 5), bronchopleural fistula (BPF) with acute respiratory distress syndrome (ARDS) (n = 1) 31(33.7%) patients had at least one major nonfatal complication. The 1, 3 and 5 year survival rates were 81%, 26% and 14% respectively.
Completion pneumonectomy for lung cancer is a safe surgical procedure for the skilled surgeon though it has a relatively higher complications and the long-term survival is acceptable.
分析中国某单一机构肺癌全肺切除术的经验。
1988年1月至2007年12月,92例患者接受肺癌全肺切除术治疗。适应证为第二原发性肺癌(n = 51)、局部转移(n = 37)和肺转移(n = 4)。初次手术与全肺切除术之间的中位间隔时间为24.4个月(1.5 - 145个月)。
无术中死亡。全肺切除手术持续4.3小时(1.5 - 8小时)。全肺切除术中失血量为1854.5毫升(200 - 9100毫升)。9例(9.78%)患者术后死亡:肺栓塞(n = 2)、多系统功能衰竭后弥散性血管内凝血(DIC)(n = 1)、对侧肺炎后呼吸衰竭(n = 5)、支气管胸膜瘘(BPF)合并急性呼吸窘迫综合征(ARDS)(n = 1)。31例(33.7%)患者至少发生一种严重非致命并发症。1年、3年和5年生存率分别为81%、26%和14%。
对于技术熟练的外科医生而言,肺癌全肺切除术是一种安全的手术方法,尽管其并发症相对较高,但长期生存率尚可接受。