Yamato Y, Souma T, Yoshiya K, Tsuchida M, Aoki T, Watanabe T, Hashimoto T, Eguchi S
Second Department of Surgery, Niigata University School of Medicine, Japan.
Kyobu Geka. 1997 Feb;50(2):114-9.
From 1980 to 1995, sixteen patients with T4 lung cancer underwent resection of left atrium (LA) or great vessels combined with pulmonary resection. For eight patients with lung cancer invading LA, LA was resected under simple clamp of LA in seven cases, and under extracorporeal circulation in one case. For three patients with lung cancer invading aorta, resection and reconstruction of aorta was performed under femoro-femoral bypass in one case, and under temporary bypass using a heparin-coated tube in two cases. For five patients with lung cancer invading superior vena cava (SVC), SVC was resected under partial clamp or simple clamp of SVC in each case. In remaining three patients, SVC was resected under internal bypass in one case, and under temporary bypass using a heparin-coated tube in two cases. Three were two operative deaths, one (SVC) died of acute heart failure, and the other (LA) died of acute respiratory distress syndrome. Four patients are alive without recurrence and three of them (one LA and two SVC) have been surviving more than five years after operation.
1980年至1995年期间，16例T4期肺癌患者接受了左心房（LA）或大血管切除联合肺切除术。对于8例肺癌侵犯LA的患者，7例在单纯钳夹LA的情况下切除LA，1例在体外循环下切除。对于3例肺癌侵犯主动脉的患者，1例在股-股旁路下行主动脉切除和重建，2例在使用肝素涂层管的临时旁路下行主动脉切除和重建。对于5例肺癌侵犯上腔静脉（SVC）的患者，均在部分钳夹或单纯钳夹SVC的情况下切除SVC。其余3例患者中，1例在体内旁路下切除SVC，2例在使用肝素涂层管的临时旁路下切除SVC。有2例手术死亡，1例（SVC）死于急性心力衰竭，另1例（LA）死于急性呼吸窘迫综合征。4例患者存活且无复发，其中3例（1例LA和2例SVC）术后存活超过5年。
