Zhou Q H
Department of Thoracocardiac Surgery, First University Hospital, West China University of Medical Sciences, Chengdu.
Zhonghua Zhong Liu Za Zhi. 1993 Sep;15(5):388-90.
From April, 1988 to April, 1992, Pneumonectomy combined with resection of a part of left atrium in the treatment of patients with stage IIIb bronchogenic carcinoma was carried out in 5 cases because that the base of the pulmonary vein or adjacent left atrium were invaded by lung cancer. The surgical indications, surgical techniques, and the main points of perioperative management are discussed. The authors emphasize that the left atrium should be resected first before the pulmonary artery and bronchus are divided; that the tumor tissue should be resected completely and the healthy left atrium be reserved if possible; and the resection of the left atrium should not be more than one third of it. Pulmonary edema and respiratory failure often occur in the postoperative period, and its severity and morbidity are heavier than those patients with pneumonectomy alone. Therefore, postoperative management is of great importance. The postoperative survivals in this group are as follows: 2 cases survived more than 4 years; 1 more than 2 years; 1 over 10 months and another one 4 months.
1988年4月至1992年4月,对5例Ⅲb期支气管肺癌患者进行了肺切除术联合部分左心房切除术,原因是肺癌侵犯了肺静脉根部或邻近的左心房。讨论了手术适应证、手术技术及围手术期管理要点。作者强调,应先切除左心房,再切断肺动脉和支气管;应彻底切除肿瘤组织,尽可能保留健康的左心房;左心房切除不应超过其三分之一。术后常发生肺水肿和呼吸衰竭,其严重程度和发病率比单纯肺切除患者更重。因此,术后管理至关重要。该组患者术后生存情况如下:2例存活超过4年;1例超过2年;1例超过10个月;另1例4个月。