非典型性局限性肺切除治疗肺恶性肿瘤的初步体会

Preliminary Experience of Nontypical Limited Resection of the Lung (NLRL)for Treatment of Pulmonary Malignancy

1989年至1995年为16例肺恶性肿瘤病人施行了26次非典型性局限性肺切除。周围型肺癌5例。1例腺癌病人（T3N2M0）于术后1年6个月死亡。其余2例腺癌（T1N0M0，T2N0M0）病人，1例肺叶切除复发的腺癌病例和1例小细胞癌（T2N0M0）病人生存至今，已分别超过3年6个月，2，和1年。肺转移瘤11例，3例为单发转移，8例为双肺多发性转移瘤。11例病人进行20次非典型性局限性切除，其切除转移瘤143个，平均每例13个。4例于术手6年，1年，10个月和8个月死亡。余7例生存至今，已分别超过3年（3例），2年（3例），1年（1例）。非典型性局限性肺切除不同于经典的肺叶切除术，肺段切除和肺楔形切除术。本手术具有不少优点：肺组织损失少，操作简便，可以切除肺组织深部病变和多发性病变，从而避免肺叶切除或全肺切除而保存更多的肺组织。

From 1989 to 1995, 26 NLRL for pulmonary malignancy were performed on 16 patients. There were 5 cases with peipheral carcinoma of the lung.1 case with adenocarcinoma(T3N2M0 ) died 1. 5 years after operation Another 2 cases with adenocarcinoma(T1N0M0, T2N0M0), 1 case with recurrent adenocarcinoma after lobectomy, and 1 case with small cell carcinoma(T2N0M0) have survived for 3. 5,2, 1, years until now respetively.There were 11 cases with metastases in the lung; 3 cases with single metastasis and 8 case with bilateral multiplemetastases. 20 NLRL were performed on 11 patients, 143 metastare in the lung were resected (averaged 13 metastases per case). 4 cases survived for 6 years, 1 year, 10 months, and 8 months postoperstively. Another 7 cases have survived for 3 years (3 cases), 2 years (3 cases), and 1 year (1 case) until now.NLRL is different for typical lobectomy, segmentectomy,and uedge resection of the lung,NLRL has some benefits: less lost of the lung tissure; simpler surgital technques; and able to reah for and more lung lesions,and avoid lobectomy more pneumonectomy, thus save more lung tissue in mecessary case.