87例支气管肺癌袖状切除术临床分析

Clinical Experience with Sleeve Resection in 87 Cases of Bronchogenic Lung Cancer

目的:探讨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87例肺癌的临床疗效。方法:对本院本科室1994年10月-2006年8月87例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的肺癌患者进行回顾性分析。结果:87例患者无手术死亡病例,发生支气管胸膜瘘1例,发生率1.14%(1/87),肺炎、肺不张5例,发生率为5.74%(5/87)。患者中位生存时间(MST)为4.2年,1、3、5、10年生存率分别为80.3%、61.5%、47.3%、31.7%。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可以最大限度保留健康肺组织,安全、有效地提高了肺癌的治愈率和远期生存率。

Objective： To summarize the clinical efficacy of bronchial sleeve lobectomy and reconstruction for 87 cases of lung cancer. Methods： From October, 1994 to August, 2006, we performed sleeve lobectomy and reconstruction in 87 cases of lung cancer. The operations included ring of bronchus or sleeve lobectomy in 64 cases, double sleeve lobectomy in 16 cases, carinal resection and reconstruction in 4 cases, and partial auricular resection in 3 cases. Results： There was no death from surgery in this series. The complications include broncho-pleural fistula in 1 case （1.14%, 1/87）, pulmonary infection and pulmonary atelectasis in 5 （5.74%, 5/87）. The median survival time was 4.2 years. The survival rates at 1, 3, 5 and 10 year were 80.3 %, 61.5 %, 47.3 % and 31,7 %, respectively, Conclusion： With the treatment of sleeve lobectomy and reconstruction, the pulmonary tissue can be substantially preserved, and the cured rate and the long term survival rate can be improved in patients with lung cancer with good safety and reliability.