摘要
Objective: Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for the patients with compromised cardiopulmonary reserve. Our experience with the procedures was reviewed and the operative technique, indication for the procedures, and long-term results were analyzed. Methods: From January 1977 to December 1996, 65 bronchoplasties, 4 pulmonary arterioplasties, and 3 combined broncho-angioplasties were performed for bronchogenic carcinoma. Of the 72 patients, thirty-one had stage I disease, 29 stage II and 12 stage III. Results: One patient (1.4%) died of bilateral pneumonitis after operation. Atelectasis occurred in 2 patients (2.8%), empyema in one (1.4%) and bronchial fistula in one (1.4%). There were no bronchial stenoses after bronchoplastic procedures, and no vascular complications after angioplastic procedures. The one-years, 3-year and 5-year survival rates for the entire group were 86.0%, 47.0%, and 29.8%, respectively. The three-year survival rates for the patients with stage I, II and III disease were 69.4%, 32.3% and 25.0%, respectively. There was no 5-year survival for patients with stage III disease, whereas for patients with stage I and II disease, the 5-year survival rates were 48.6% and 10.8%, respectively. The difference in survival was significant between stage I and II disease (P=0.0001) and between stage I and III disease (P<0.0001), but not between stage II and III (P=0.0779). Conclusion: Bronchoplastic, pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Brochoplastic procedures offer patients with bronchogenic carcinoma a long-term result comparable to that for radical lung resections. Angioplastic and combined angio-bronchoplastic procedures should only be employed in the patients who can not tolerate a pneumonectomy due to poor carciopulmonary reserve.
Objective: Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for the patients with compromised cardiopulmonary reserve. Our experience with the procedures was reviewed and the operative technique, indication for the procedures, and long-term results were analyzed. Methods: From January 1977 to December 1996, 65 bronchoplasties, 4 pulmonary arterioplasties, and 3 combined broncho-angioplasties were performed for bronchogenic carcinoma. Of the 72 patients, thirty-one had stage I disease, 29 stage II and 12 stage III. Results: One patient (1.4%) died of bilateral pneumonitis after operation. Atelectasis occurred in 2 patients (2.8%), empyema in one (1.4%) and bronchial fistula in one (1.4%). There were no bronchial stenoses after bronchoplastic procedures, and no vascular complications after angioplastic procedures. The one-years, 3-year and 5-year survival rates for the entire group were 86.0%, 47.0%, and 29.8%, respectively. The three-year survival rates for the patients with stage I, II and III disease were 69.4%, 32.3% and 25.0%, respectively. There was no 5-year survival for patients with stage III disease, whereas for patients with stage I and II disease, the 5-year survival rates were 48.6% and 10.8%, respectively. The difference in survival was significant between stage I and II disease (P=0.0001) and between stage I and III disease (P<0.0001), but not between stage II and III (P=0.0779). Conclusion: Bronchoplastic, pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Brochoplastic procedures offer patients with bronchogenic carcinoma a long-term result comparable to that for radical lung resections. Angioplastic and combined angio-bronchoplastic procedures should only be employed in the patients who can not tolerate a pneumonectomy due to poor carciopulmonary reserve.
