支气管肺动脉成形术治疗中央型支气管肺癌

Bronchus Pulmonary Arterioplasty for Central Type Bronchiogenic Cancer

目的:探讨支气管肺动脉成形术治疗中心型肺癌的效果。方法:1998年12月至2008年12月对16例中央型肺癌施行支气管肺动脉联合成形肺叶切除,包括双袖式左肺上叶切除7例;双袖式右肺上叶切除2例;双袖式右肺中上叶切除2例;双袖式右肺中上叶切除同时隆突重建2例;袖式左上肺叶切除、肺动脉楔形切除2例;袖式右肺中上叶切除、肺动脉楔形切除1例。结果:本组无死亡及吻合口瘘发生,术后2例出现肺不张,2例并发肺感染,全组术后1年生存率为93.8%,3年生存率为62.5%。结论:肺动脉成形或肺动脉支气管同时成形肺叶切除减少了全肺切除和单纯剖胸探查的比例,扩大了手术适应征,符合最大限度地切除肿瘤及最大限度保留肺功能的肺癌手术基本原则,是一种安全、有效、可行的术式。

Objective： To explore the therapeutic effect of Bronchus pulmonary arterioplasty for central type bronchiogenic cancer. Methods： Fourteen cases of central type lung cancer from December, 1998 to December, 2008 were treated by Bronchus pulmonary arterioplasty combined with pulmonary lobectomy （including 7 cases with double sleeve resection of left middle-upper lobe; 2 cases with double sleeve resection of right upper lobe; 2 cases with double sleeve resection of right middle-upper lobe; 2 cases with double sleeve resection of right middle--upper lobe and carinal reconstruction; 2 cases with sleeve resection of left upper lobe and wedge section of pulmonary artery; 1 case with sleeve resection of right middle upper lobe and wedge section of pulmonary artery. Results： No death and stoma fistula occurred. Two cases had pulmonary closure and 2 cases complicated with pulmonary infection after operation. In the whole group, 1-year survival rate was 93.8M, 3-year survival rate was 62.5%. Conclusion： Pulmonary arterioplasty or combined with bronchoplasty reduces the ratio of total pneumotomy and simple exploratory thoracotomy and extends the operation indications. It complies with the basic principle for lung cancer operation that is utmost resection of tumor and utmost reservation of pulmonary function. It＇s a safe, effective and feasible operation procedure.