支气管肺动脉成形术治疗中央型肺癌的临床分析

Clinical analysis of bronchoplasty and pulmonary arterioplasty for the treatment of central-type lung cancer

目的探讨支气管肺动脉成形术治疗肺癌的效果。方法自2003年至2005年对36例肺癌患者施行支气管肺动脉同时成形术。术后病理诊断结果：鳞癌24例，腺癌6例，腺鳞癌5例，小细胞未分化癌1例。pTNM分期：ⅡB期5例（T2N1M0 4例，T3N0M0 1例），ⅢA期27例（T3N1M0 11例，T2N2M0 9例，T3N2M0 7例），ⅢB期4例（T4N0M0 1例，T4N1M0 1例，T4N2M0 2例）。结果该组手术近期死亡0例。术后1、3、5年生存率分别为74％（26／35）、48％（11／23）、33％（3／9）。结论采用支气管肺动脉同时成形术治疗中央型肺癌减少了全肺切除和单纯剖胸探查的率扩大了手术适应证，为肺癌患者提供了更有效、安全、合理的治疗机会。

Objective The aim of this study is to review the surgical experience of bronchoplasty and pulmonary arterioplasty in treatment of central-type lung cancer. Methods From 2003 to 2005,36 cases of patients with central-type lung cancer underwent bronchoplasty and pulmonary arterioplasty. There were 28 males and 8 females with a mean age of 62 years. According to pTNM classification. 5 cases were in stage Ⅱ B,and 27 in stage Ⅲ A and 4 in stage Ⅲ B. Histologically,there were 24 cases of squamous cell carcinoma,6 cases of adenocarcinoma,1 ease of small cell lung cancer and 5 cases of adenosquamous carcinoma. Results No patients died in the perioperative period. The overall 1-,3-, and 5-year survival rate were 74% （26/35） ,48% （11/23） and 33% （3/9） ,respectively. Conclusion The results suggest that bronchoplasty and pulmonary arterioplasty can decrease the proportions of total pneumonectomy and exploratory thoracotomy and expand the indication of operation. Bronchoplasty and pulmonary artefioplasty can be achieved with satisfactory outcome for central-type lung cancer,especially for those patients with advanced lesions or poor pulmonary function.