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全肺切除术治疗肺癌:早期和长期疗效

Completion pneumonectomy for lung cancer treatment: early and long term outcomes.

作者信息

Zhang Peng, Jiang Chao, He Wenxin, Song Nan, Zhou Xiao, Jiang Gening

机构信息

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, Peoples Republic of China.

出版信息

J Cardiothorac Surg. 2012 Oct 9;7:107. doi: 10.1186/1749-8090-7-107.

Abstract

BACKGROUND

To analyze the experience of completion pneumonectomy for lung cancer at a single institution in China.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

分析中国某单一机构肺癌全肺切除术的经验。

方法

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)。

结果

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%。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e717/3493293/385b408e3ab5/1749-8090-7-107-1.jpg

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