气管隆突切除及重建术治疗中心型支气管肺癌

Resection and Reconstruction of the Tracheal Carina in the Treatment of Central Type Bronchogenic Carcinoma

本文报告１０例侵及气管隆突或距隆突０．３ｃｍ以内的中心型支气管肺癌行气管隆突切除及重建术，其中右上叶及隆突切除重建术３例，右全肺及隆突切除２例，左全肺及隆突切除４例，左上叶及隆突切除重建术１例，加部分左心房切除术３例。本组根治切除９例。姑息切除１例。术后并发症３例（３０％）。术后无癌生存６年１例，３年１例，２年１０月１例，２年６月３例，１年２例，半年１例；另１例于术后８月死于脑转移。重点讨论了手术适应证、手术方法、围手术期监护和处理。

From March 1988 to september 1993, ten patients with bronchoganic careinoma underwent resection and reconstrution of the tracheal carina. The modes of operation were as follows: right upper lobectomy combined with reconstruction of the carina in 3 cases, right and left pneumonectomy with complete resection of the carina in 2 cases and 4 cases respectively, left upper lobectomy with reconstruction of the carina in 1 case, and with partial resection of left atrium in 3 cases . Nine patients had radical resection of the cancer, and one palliative. Three patieats had postoperative complications (39%). One patients survived for more than 6 years, 1 more than 3 years. 4 over 2 years and 6 months, 2 more than 1 year and another case more than 6 months without recurrence or metastasis of the cancer after operation.However, one patient dead 8 months after removal of the cancer because of brain metastasis of the tumor.In this paper, the indications, operative techniques, and peri-operative care and management of this procedure have been discussed.