Zhang D W
Cancer Institute Hospital, Chinese Academy of Medical Science, Beijing.
Zhonghua Wai Ke Za Zhi. 1993 Mar;31(3):138-40.
135 cases of lung cancer were treated by sleeve (bronchoplastic) lobectomy within 24 years. 90 (66.7%) of them were of squamous cell carcinoma. Postoperative TNM classification showed 81 cases (60.0%) of stage I disease, 33 (24.4%) of stage II, 20 (14.8%) of stage III and 1 (0.7%) of stage IV. Upper lobe sleeve resection was used in 77.7% of the cases (right upper 57, left upper 48). Left upper sleeve lobectomy in 5 cases was accompanied by sleeve resection and reanastomosis of the left main pulmonary artery. One patient (0.7%) died of pulmonary thrombosis. The morbidity rate was 6.6%. Late complications included scar stricture of the anastomosis in 16 cases and recurrence at the site of anastomosis in 5. The 5- and 10-year survival rate was 56.2% and 42.9% respectively. For squamous cell carcinoma in particular, the 5-year survival was 60%. The indications and techniques of this operation are discussed in detail. Sleeve lobectomy had the advantages of preserving as much normal lung tissue as possible while keeping the principle of radical resection uncompromised. The low operative mortality and good long-term survival warrant its popularization.
24年间,135例肺癌患者接受了袖状(支气管成形)肺叶切除术。其中90例(66.7%)为鳞状细胞癌。术后TNM分期显示,I期疾病81例(60.0%),II期33例(24.4%),III期20例(14.8%),IV期1例(0.7%)。77.7%的病例采用上叶袖状切除术(右上叶57例,左上叶48例)。5例左上叶袖状肺叶切除术同时进行了左主肺动脉袖状切除及再吻合术。1例患者(0.7%)死于肺血栓形成。发病率为6.6%。晚期并发症包括16例吻合口瘢痕狭窄和5例吻合口复发。5年和10年生存率分别为56.2%和42.9%。特别是鳞状细胞癌,5年生存率为60%。详细讨论了该手术的适应证和技术。袖状肺叶切除术具有在不影响根治原则的前提下尽可能保留正常肺组织的优点。较低的手术死亡率和良好的长期生存率使其值得推广。