Sato M, Takagi K, Kawakami T, Deguchi H, Watanabe M, Aoki T, Tsumatori G, Tanaka S, Ogata T
Department of Surgery II, National Defence Medical College, Saitama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Jan;45(1):12-6.
We studied 10 lung cancer patients with pneumonia insusceptible of conservative treatment. All patients underwent urgent pulmonary resection to control their pneumonia induced by the tumor and to cure the cancer. The causes of pneumonia were bronchial obstruction by the tumor itself or aspiration of the tumor necrosis. The patients comprised 9 men and 1 women. The age range was 37 to 72 years with a median age of 57 years. There were obstructive pneumonia in 3 patients and aspiration pneumonia in 7 cases. The average size of tumor was about 4.7 and 7.5 cm, respectively. The histological type of lung cancer was squamous cell carcinoma in 6 and adenocarcinoma in 4. There were 1 stage 1,1 stage IIIA and 3 stage IIIB tumors. Lobectomy was performed in 8 patients and pneumonectomy in 2 patients. Nine patients underwent the operation under one-lung ventilation. A median period of preoperative administration of antibiotics was 6.2 days. The curative operation for lung cancer was performed in 3 patients and non-curative operation in 7 patients. Postoperative complications were pneumonia in 2, subcutaneous abscess in 2 and arrhythmia in a case of pneumonectomy. All non-curative patients died in 5 years, but two curative patients survived long time for 31 and 75 months, respectively. We performed urgent pulmonary resection for lung cancer patients to cure fatal pneumonia and cancer. There were no hospital death. Urgent pulmonary resection could prevent early death caused by fatal pneumonia by tumor itself.
我们研究了10例无法进行保守治疗的肺癌合并肺炎患者。所有患者均接受了紧急肺切除术，以控制肿瘤引起的肺炎并治愈癌症。肺炎的病因是肿瘤本身导致的支气管阻塞或肿瘤坏死物的误吸。患者包括9名男性和1名女性。年龄范围为37至72岁，中位年龄为57岁。其中3例为阻塞性肺炎，7例为误吸性肺炎。肿瘤平均大小分别约为4.7厘米和7.5厘米。肺癌的组织学类型为鳞状细胞癌6例，腺癌4例。有1例I期、1例IIIA期和3例IIIB期肿瘤。8例行肺叶切除术，2例行全肺切除术。9例患者在单肺通气下进行手术。术前抗生素使用中位时间为6.2天。3例患者进行了肺癌根治性手术，7例患者进行了非根治性手术。术后并发症包括2例肺炎、2例皮下脓肿和1例全肺切除术后的心律失常。所有非根治性患者均在5年内死亡，但2例根治性患者分别存活了31个月和75个月。我们对肺癌患者进行紧急肺切除术以治愈致命性肺炎和癌症。无医院死亡病例。紧急肺切除术可预防肿瘤本身导致的致命性肺炎引起的早期死亡。
