Kodama K, Doi D, Higashiyama M, Yokouchi H, Kabuto T, Kobayashi T, Hiraishi T
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Kyobu Geka. 1995 May;48(5):367-71.
Four lung cancer patients underwent left pneumonectomy combined with resection of the descending aorta. Their tumors arose from the superior segment (S6) of the left lower lobe and directly invaded the aorta. Their angles of contact with descending aorta were more than 130 degrees. There were two squamous cell carcinoma, and one each of large cell carcinoma, and adenosquamous carcinoma. In Case 1, the defect of the descending aorta was closed by patch graft using simple aortic cross-clamping. In the other three patients, the aorta was replaced by a 5-7 cm long woven Dacron tube graft under temporary bypass using Anthron tube. Their postoperative courses were uneventful. Although the follow-up period is too short at present, two cases (3 and 4) have been alive without recurrence for five and two months, respectively. The induction chemotherapy followed by extended surgery (Case 4) may become a feasible treatment modality to overcome the poor prognosis in patients with advanced lung cancer invading to the great vessels.
四名肺癌患者接受了左肺切除术并联合降主动脉切除术。他们的肿瘤起源于左肺下叶的上段（S6）并直接侵犯主动脉。他们与降主动脉的接触角度超过130度。其中有两例为鳞状细胞癌，一例大细胞癌和一例腺鳞癌。病例1中，降主动脉缺损通过单纯主动脉交叉钳夹下的补片移植进行修复。在其他三名患者中，使用Anthron管在临时旁路下用一段5 - 7厘米长的编织涤纶人工血管替换主动脉。他们的术后病程平稳。尽管目前随访期较短，但有两例（病例3和4）分别已存活5个月和2个月且无复发。先行诱导化疗再行扩大手术（病例4）可能成为克服晚期肺癌侵犯大血管患者预后不良的一种可行治疗方式。
