支气管袖状切除术治疗中央型肺癌79例

Combined procedure of resection and construction of bronchus,great vessels and heart in the treatment of central lung cancer

目的 总结采用以支气管袖状成形肺叶切除术为核心的多种切除重建术式治疗79例中央型肺癌的临床疗效。方法1988年6月～2005年6月，对79例中央型肺癌患者施行以支气管袖状成形肺叶切除术为核心的多种切除重建手术。支气管环状切除成形及支气管袖状成形肺叶切除术57例；支气管肺动脉双袖状成形肺叶切除术15例；气管隆突及半隆突切除重建合并肺叶切除术6例。结果 本组无手术死亡病例。发生手术并发症7例次，发生率为8．86％。术后1、3、5和10年生存率分别为78．5％，59．5％，35．4％，17．7％。结论 以支气管袖状成形肺叶切除术为核心的多种切除重建术式能最大限度保护了肺功能，提高了中央型肺癌的治愈率和远期生存率。

Objective To summarize the clinical results of combined procedure of resections and constructions of bronchus, great vessels and heart in the treatment of 79 patients with central lung cancer. Methods From Jun, 1988 to Jun, 2005, the combined procedure of resections and constructions of bronchus, great vessels and heart were carried out in 74 patients with central lung cancer. The operations included ring of bronchus or sleeve lobectomy in 57 cases, double sleeve lobectomy in 15 cases, carinal resection and reconstruction in 4 cases. Results There was no operative deaths and 7 （8. 86 % ） patients had operative complications. The survival rates of 12,36,60 months and 10 years were 78. 5% ,59. 5% ,35.4% and 17. 7% respectively. Conclusion With the treatment of sleeve lobectomy or combined with resection and reconstruction of pulmonary artery, great vessels or heart, the pulmonary function can be protected significantly, and the cure rate and the long term survival rate can be improved in patients with central lung cancer.