Dartevelle P G, Khalife J, Chapelier A, Marzelle J, Navajas M, Levasseur P, Rojas A, Cerrina J
Department of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Plessis Robinson, France.
Ann Thorac Surg. 1988 Jul;46(1):68-72. doi: 10.1016/s0003-4975(10)65855-9.
From 1966 to 1986, a total of 55 patients underwent a tracheal sleeve pneumonectomy (53 right and 2 left) for bronchogenic carcinoma. Preoperative radiotherapy was given in only 5 patients. The overall operative death rate was 10.9%, but no patient has died since 1975 (32 survivors). Seven patients had a postoperative empyema (12.7%); 4 of these patients had a bronchopleural fistula. Twenty-five patients had postoperative radiotherapy, 5 of whom also had chemotherapy. The actuarial survival rate, after exclusion of the 6 operative deaths, was 38% at 3 years and 23% at 5 years. Survival was correlated to regional lymph node involvement. The actuarial survival rate among patients with tumoral spread to bronchial lymph nodes was 43% at 3 years. Among the 13 patients with only subcarinal involvement, the actuarial survival rate was 34% at 3 years. None of the 8 patients with paratracheal lymph node involvement survived more than 30 months. These results indicate that tracheal sleeve pneumonectomy for bronchogenic carcinoma with extension to the carina is now fully justified considering the low operative mortality and the good results observed when lateral tracheal lymph nodes were not involved.
1966年至1986年期间，共有55例患者因支气管源性癌接受了气管袖状肺叶切除术（53例右侧，2例左侧）。仅5例患者术前接受了放疗。总体手术死亡率为10.9%，但自1975年以来无患者死亡（32例幸存者）。7例患者术后发生脓胸（12.7%）；其中4例患者发生支气管胸膜瘘。25例患者术后接受了放疗，其中5例还接受了化疗。排除6例手术死亡病例后，3年的精算生存率为38%，5年为23%。生存率与区域淋巴结受累情况相关。肿瘤扩散至支气管淋巴结的患者3年精算生存率为43%。在仅隆突下受累的13例患者中，3年精算生存率为34%。8例气管旁淋巴结受累的患者均未存活超过30个月。这些结果表明，考虑到手术死亡率低以及未累及气管旁淋巴结时观察到的良好结果，对于累及隆突的支气管源性癌行气管袖状肺叶切除术目前是完全合理的。
