心包内全肺切除24例体会

Intrapericardial Pneumonectomy.An Analysis of 24 Cases

本文总结了24例心包内全肺切除治疗肺癌的体会。讨论了心包内全肺切除的手术技巧,以及术中所可能发生的意外情况处理。提出了该术式的手术适应症为①中心型肺癌瘤体较大并累及或包绕心包外肺血管干,无法按正常程序处理者。②肺癌累及肺门附近的心包。③手术中解剖肺血管时不慎误伤出血而无法在心包外处理者。心包内全肺切除使一些中、晚期的肺癌增加了手术切除的可能性。

This article reports the experiences in doing intrapericardial pneumonectomy in 24 patients with lung cancer. The operative technique and the treatment of complications during operation were discussed. The indication of this kind of operation were: (1)Large central lung cancer with adjacent tissues involvement but intact pericardium; (2)Lung cancer involves the pericardium only at the hilum; (3)Involvement of major blood vessel that made it impossible to treat outside of pericardium. Intrapericardial pneumonectomy offered better results as compared with those following mere exploratomy thoracotomy in cases of medium and late stage malignant tumor. Intensive adjuvant chemotherapy may be added to achieve better results.