Horinouchi H, Kohno M, Kuwabara K, Gika Y, Tajima A, Yoshizu A, Naruke M, Kawamura M, Kikuchi K, Kobayashi K
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Kyobu Geka. 1997 Feb;50(2):128-32.
By 1995, 17 patients with lung cancer invading the carina underwent surgical resection and reconstruction of the carina. Procedures which applied to patients were two cases of wedge pneumonectomy, seven cases of sleeve pneumonectomy, four cases of carinal reconstruction with right upper lobectomy, and four cases of carinal resection and reconstruction. Overall survival for five years were 40.3% and 33.6% for ten years survival. Operative death occurred in 5 cases. Long term survival was achieved in localized diseases which showed no lymph node extension. As for N1 and N2 diseases, only one patient among 7 cases survives 12 months. Thus we conclude that selected cases which showed localized disease without lymph node extension are the candidate for carinal resection and reconstruction. Postoperative intensive care is mandated for these patients. Adjuvant therapy with surgery for these patients with lymph node progression is a future problem.
到1995年,17例肺癌侵犯隆突的患者接受了手术切除及隆突重建。应用于患者的手术方式有2例楔形肺切除术、7例袖状肺叶切除术、4例右肺上叶切除隆突重建术以及4例隆突切除重建术。五年总生存率为40.3%,十年生存率为33.6%。手术死亡5例。局限期且无淋巴结转移的患者获得了长期生存。对于N1和N2期疾病,7例患者中仅有1例存活12个月。因此我们得出结论,局限期且无淋巴结转移的特定病例是隆突切除重建的候选对象。这些患者术后必须进行重症监护。对于这些有淋巴结转移进展的患者,辅助手术治疗是未来需要解决的问题。