肺动脉切除成形改进技术治疗中心型非小细胞肺癌

Improved techniques of pulmonary artery resection in the treatment of locally advanced non - small cell lung cancer

目的总结肺动脉切除成形改进技术在肺癌外科治疗中应用的经验。方法对29例中心型非小细胞肺癌侵犯肺动脉的患者行肺动脉切除重建术。控制肺动脉的近、远端手术者19例（A组），改进后控制主肺静脉手术者10例（B组）。结果全组无手术死亡。B组手术时间、术中出血量均低于A组，两组术后并发症和生存率差异无统计学意义。结论肺动脉切除成形能够避免一些全肺切除，夹闭控制主肺静脉代替控制肺动脉远端的方法能提高更大的手术操作空间，而且安全，没有破坏肺循环的生理，没有影响局部复发率和长期生存率。

Objective To assess our experience in improved techniques of the pulmonary artery resection in the surgical treatment of lung cancer. Methods The data of 29 patients with center lung cancer who underwent pulmonary artery resection were retrospectively. Nineteen patients were subjected to proximal and distal control of the pulmonary artery （group A）. The improved technique with distal control of the pulmonary artery by clamping the vein （ not the artery） was performed on 10 patients （ group B）. Results There was no mortality in our groups and all patients recovered well. The operative time was shorter and blood loss during operation was less in group B than in group A. But there was no statistically significant difference in morbidity and survival rate between groups A and B. Conclusion Pulmonary artery resection and reconstruction to avoid pneumonectomy can be performed safely. Clamping of the remaining pulmonary vein for distal control is safe and affords more room. It does not impede blood flow, and does not compromise local recurrence rate or long - term survival.