Sakamoto T, Ishii N, Okada M, Yamagishi H, Matsuoka H
Department of Surgery, Kobe University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1302-6.
We evaluated the results and operative indications of bronchoplastic lobectomy in patients with bronchogenic carcinoma. From 1980 to 1992, 34 patients underwent lobectomy in combination with bronchoplastic procedure for lung cancer. In regard to histological typing, they consisted of 18 squamous cell carcinoma, 9 adenocarcinomas, 3 large-cell carcinomas, 2 combined types of adenocarcinoma and squamous cell carcinoma, 1 small-cell carcinoma, and 1 carcinosarcoma. Five-year survival rate of 18 cases of squamous cell carcinoma was 41.2%, whereas 9 cases of adenocarcinoma died within 3 years. We classified 34 cases into two groups according to the reason of indication for bronchoplasty. Group T (n = 19) was the case whose tumor was spreading to the major bronchus. Group LN (n = 14) was the case whose metastatic lymph nodes were invading to the major bronchus. Forty-two percent of Group T was stage III or IV, while 93% of Group LN was stage III or IV. Five-year survival rate was 54.7% in Group T, and 8.1% in Group LN. There were statistical differences between both groups (p < 0.05). In 73 patients who underwent pneumonectomy at the same period, 5-year survival rate was 31.7%. In conclusion, the bronchoplastic procedure is recommended to Group T in comparison with that of Group LN.
我们评估了支气管肺癌患者行支气管成形肺叶切除术的结果及手术指征。1980年至1992年,34例患者因肺癌接受了肺叶切除术联合支气管成形术。在组织学类型方面,包括18例鳞状细胞癌、9例腺癌、3例大细胞癌、2例腺癌与鳞状细胞癌混合型、1例小细胞癌和1例癌肉瘤。18例鳞状细胞癌患者的5年生存率为41.2%,而9例腺癌患者在3年内死亡。我们根据支气管成形术的指征原因将34例患者分为两组。T组(n = 19)为肿瘤侵犯主支气管的病例。LN组(n = 14)为转移淋巴结侵犯主支气管的病例。T组42%为Ⅲ期或Ⅳ期,而LN组93%为Ⅲ期或Ⅳ期。T组5年生存率为54.7%,LN组为8.1%。两组之间存在统计学差异(p < 0.05)。同期接受全肺切除术的73例患者中,5年生存率为31.7%。总之,与LN组相比,支气管成形术推荐用于T组。