Spaggiari L, Grunenwald D, Girard P, Baldeyrou P, Filaire M, Dennewald G, Saint-Maurice O, Tric L
Department of Thoracic Surgery, Institut Mutualiste Montsouris, Paris, France.
Ann Thorac Surg. 1996 Dec;62(6):1598-602. doi: 10.1016/s0003-4975(96)00608-x.
After pneumonectomy for bronchogenic carcinoma, the residual lung may be the site of a new lung cancer or metastatic spread.
From 1989 to 1995, 13 patients with carcinoma on the residual lung after pneumonectomy for lung cancer were operated on. Three segmentectomies and 7 simple wedge resections were performed, 2 patients had multiple wedge resections, and 1 patient had an exploratory thoracotomy. Nine patients had a primary metachronous bronchogenic carcinoma, 3 had metastases from bronchogenic carcinoma, and no definite conclusion was reached in 1 case.
No postoperative mortality was observed. Four patients had postoperative complications. The mean postoperative hospital stay was 14 days. Seven patients are alive, including 5 patients without evidence of disease. Six patients died of their disease, all with pulmonary recurrences. The overall median survival was 19 months, with a probability of survival at 3 years (Kaplan-Meier) of 46% (95% confidence interval, 22% to 73%).
Limited pulmonary resection for lung cancer after pneumonectomy for bronchogenic carcinoma is feasible with very low morbidity. In highly selected patients, surgical resection might prolong survival.
在因支气管源性肺癌行肺切除术后，残余肺可能成为新发肺癌或转移扩散的部位。
1989年至1995年，对13例因肺癌行肺切除术后残余肺发生癌的患者进行了手术。其中3例行肺段切除术，7例行单纯楔形切除术，2例患者行多次楔形切除术，1例患者行剖胸探查术。9例为原发性异时性支气管源性肺癌，3例为支气管源性癌转移，1例未得出明确结论。
未观察到术后死亡病例。4例患者出现术后并发症。术后平均住院时间为14天。7例患者存活，其中5例无疾病证据。6例患者死于疾病，均为肺部复发。总体中位生存期为19个月，3年生存率（Kaplan-Meier法）为46%（95%置信区间，22%至73%）。
因支气管源性肺癌行肺切除术后，对残余肺的肺癌进行有限的肺切除术是可行的，发病率极低。在经过严格挑选的患者中，手术切除可能会延长生存期。
