左肺上叶癌的外科治疗

Surgery treatment of left upper lobe lung cancer

目的:探讨左肺上叶癌外科治疗的经验和体会。方法:对87例左肺上叶癌患者(中央型肺癌47例,周围型肺癌40例)行手术治疗,其中左肺上叶双袖状切除39例,单袖状切除12例,左全肺切除3例,左肺上叶切除33例。结果:手术均顺利,术后生活质量均良好,无围手术期死亡,术后并发症以心律失常多见。左肺上叶双袖状切除术39例中共行气管镜吸痰9例(23.1%),发生房颤者8例(20.5%),高于单纯左肺上叶切除术(9.1%)和(6.1%),但差异无统计学意义(P>0.05)。结论:双袖状切除是左肺上叶中央型肺癌的主要术式,选择合适的患者,正确的手术探查是手术成功的关键。

Objective： To explore the experience of surgery treatment of left upper lobe lung cancer. Methods： From Oct, 2003 to Oct, 2005, 87 patients with left upper lobe lung cancer, 47 central and 40 peripulmonary, aged 31 to 78, were undergone operation such as sleeve resection, double sleeve resection and total pneumonectomy. Results： Eighty-seven cases were all successfully treated. All cases were in good quality of life and enjoyed normal entertainments and work without severe complications, cardiac arrhythmia was the most common complication. There was no sharp difference among complications occurance between double sleeve resection and left upper lobe pneumonectomy （9.1%） vs （6.1%）, P 〉0.05. Conclusions： Double sleeve resection is an effective treatment for patients with left upper lobe lung cancer, especially central one, appropriate selections of patients are guarantee for the ultimate results of surgical treatment.