逆行肺叶切除在肺癌手术中的意义(附28例报告)

Advantage of retrograde pulmonary lobectomy in lung cancer operation

目的:探讨逆行肺叶切除术在肺癌手术中的优点。方法:对28例因受肿瘤、淋巴结压迫或侵犯,肺动脉或肺静脉显露困难的肺癌病人行逆行肺叶切除术病例(实验组)进行回顾性分析,并以同期同类型肺癌病人常规肺叶切除术30例当对照组进行分析。结果:实验组28例均顺利完成肺叶切除,切除率100%,对照组探查3例,全肺切除6例,肺叶切除21例,切除率90%,术中术后并发症:实验组术中出血8例,平均手术时间2.5小时,术后平均住院9天;对照组术中出血18例,改行全肺切除6例,平均手术时间3.5小时,术后平均住院12天。结论:逆行肺叶切除术能显著提高肺癌的手术切除率,减少全肺切除,术中出血少,手术时间短,术后恢复快。

Objective： To explore the advantage of retrograde pulmonary lobectomy in lung cancer operation. Methods： Retrospectively analysed 28 patients （study group） with lung cancer, who were difficult to show the pulmonary artery and the pulmonary vein during operation because of being oppressed and invaded by the tumor or the lymph node and all undergone the retrograde pulmonary lobectomy. Compared with the results of 30 patients （control group） who had the lung cancer in the same situation at the same time but had the routine lobectomy. Results： All 28 patients in study group had the pulmonary lobectomy and the resectability （ 100% ）. In control group, 3 patients had the exploration, 6 had the total pneumonectomy and 21 had the pulmonary lobectomy, the resectability was 90%. Intraoperative and postoperative complications. In study group, 8 patients had the intraoperative hematorrhea, the average of operative time was 2.5 hours and the postoperative hospitalization days were 9 days. In control group, 18 patients had the intraoperative hematorrhea, 6 patients undergone the total pneumonectomy at last, the average operative time was 3.5 hours and the postoperative hospitalization days were 12 days. Conclusion： The retrograde pulmonary lobectomy can improve the resectability of lung cancer markedly and reduce the rate of the total pneumonectomy, reduce the intraoperative hematorrhea, shorten the operative time.