Yamato Y, Hirono T, Souma T, Yoshiya K, Nakayama K, Tsuchida M, Aoki T, Watanabe T, Eguchi S, Yamaguchi A
Second Department of Surgery, Ni igata University School of Medicine, Japan.
Kyobu Geka. 1995 Jan;48(1):24-8.
From 1975 to July 1994, twenty patients underwent second or third pulmonary resections for 7 recurrent lung cancers and 14 second primary lung cancers. The initial surgical procedures were lobectomy in 18, pneumonectomy in 1 and bilateral segmentectomy in 1. The procedures at the second operation were completion pneumonectomy in 4, ipsilateral wedge resection in 3, contralateral lobectomy in 1, contralateral segmentectomy in 4, contralateral wedge resection in 7 and resection of left main bronchus in 1. At the third operation, wedge resection was done in one 28 months after completion pneumonectomy. There was no operative death following second and third operations. Five-year survival rate following second operation in 20 patients was 32.3%, and it was 28.6% for patients with recurrent lung cancers, and 31.2% for multiple primary lung cancers. In conclusion, an aggressive surgical approach for reappearing lung tumor should be performed. At the reoperation, wedge resection for recurrent lung cancers, completion pneumonectomy for ipsilateral primary lung cancers and segmentectomy for contralateral primary lung cancers should be chosen for the standard surgical procedure.
从1975年至1994年7月，20例患者因7例复发性肺癌和14例第二原发性肺癌接受了二次或三次肺切除术。初次手术方式为肺叶切除术18例、全肺切除术1例、双侧肺段切除术1例。二次手术的术式为全肺切除术4例、同侧楔形切除术3例、对侧肺叶切除术1例、对侧肺段切除术4例、对侧楔形切除术7例、左主支气管切除术1例。第三次手术是在全肺切除术后28个月进行了1例楔形切除术。二次和三次手术后均无手术死亡。20例患者二次手术后的5年生存率为32.3%，复发性肺癌患者为28.6%，多原发性肺癌患者为31.2%。总之，对于复发性肺肿瘤应采取积极的手术方法。再次手术时，复发性肺癌应选择楔形切除术，同侧原发性肺癌应选择全肺切除术，对侧原发性肺癌应选择肺段切除术作为标准手术方式。
