气管隆突重建、支气管成形术治疗中央型肺癌32例

Tracheal Carina Reconstruction and Bronchoplasty in the Treatment of 32 Central Type Bronchogenic Carcinomas

【目的】分析气管隆突重建、支气管成形肺切除术治疗中央型肺癌的近期及远期疗效。【方法】自1995年5月到2006年12月共手术治疗原发性肺癌520例,其中气管隆突切除6例、支气管成形肺叶切除术26例,合计为32例。【结果】术后发生肺不张3例,心律失常1例,无手术死亡,术后1年生存率78.1%(25/32),3年生存率56.3%(18/32),5年生存率37.5%(12/32)。【结论】支气管成形术治疗肺癌是一成熟的术式,疗效取决于疾病的分期和正确的适应证选择,术中的根治切除和术后的综合治疗。

[Objective]To analyze the short term effects and long term survival of patients with lung cancer undergoing tracheal carina reconstruction and bronchoplasty.[Methods]From May 1995 to December 2006,32 patients with lung cancer underwent tracheal carina reconstruction and bronchoplasty,6 for carinal resection and reconstruction and 26 for bronchial sleeves.[Results]Postopertive complications were atelectasis（3 cases）,arrhythmia（2 cases）.There was no operative death in this series.The 1-,3-and 5-year survival rates were 78.1%（25/32）,56.3%（18/32） and 37.5%（12/32） respectively for the entire group.The indication of these procedures and the methods of lymph node dissection,bronchoplasty and pulmonary artery reconstruction,and superior vena cava reconstruction had been discussed.[Conclusion]Bronchoplasty for lung cancer is a safe and effective therapy.The long term survival depends on the stage of lung cancer,proper selection of surgical indication,clearance of lymph nodes in operation and multiple modality therpay after operation.