Belli L, Meroni A, Rondinara G, Beati C A
J Thorac Cardiovasc Surg. 1985 Aug;90(2):167-71.
Nineteen patients with primary bronchogenic carcinoma underwent bronchoplastic procedures (six wedge and 13 sleeve resections) between 1970 and 1982. In six of them lobectomy was combined with sleeve resection and reconstruction of the pulmonary artery: In one a synthetic prosthesis was inserted. Twelve patients had squamous cell carcinoma, five adenocarcinoma, and two large cell carcinoma. No operative deaths were observed, and the 5 year survival rate is 28.1%. One patient had an early bronchial fistula and two patients had bronchial stenosis (one suture granulation and one local recurrence). No patient with resection of the pulmonary artery had vascular complications. Survival rates on the basis of nodal involvement indicate 50% survival at 5 years without nodal metastasis (11 cases) versus 9.7% with nodal involvement (eight cases) (p less than 0.05). Bronchoplastic procedures, even if accompanied by segmental resection of the pulmonary artery, can be performed safely with long-term results comparable to those following major pulmonary resections.
1970年至1982年间,19例原发性支气管肺癌患者接受了支气管成形术(6例楔形切除术和13例袖状切除术)。其中6例患者行肺叶切除术联合袖状切除术及肺动脉重建术:1例植入了人工合成假体。12例为鳞状细胞癌,5例为腺癌,2例为大细胞癌。未观察到手术死亡病例,5年生存率为28.1%。1例患者出现早期支气管瘘,2例患者出现支气管狭窄(1例为缝线肉芽肿,1例为局部复发)。行肺动脉切除术的患者未出现血管并发症。根据淋巴结受累情况的生存率显示,无淋巴结转移的患者5年生存率为50%(11例),而有淋巴结受累的患者为9.7%(8例)(p<0.05)。支气管成形术,即使伴有肺动脉节段性切除术,也可安全进行,长期效果与主要肺切除术后的效果相当。