局限性胸膜、肺切除术治疗肺癌伴癌性胸水

Limited pleuro pneum onecto my for bronchogenic carcinom a associated with cancerous pleural effusion

目的 探讨局限性胸膜、肺病灶切除术治疗肺癌伴癌性胸水的可行性。 方法 １９９４年１ 月～１９９７ 年１２ 月采用局限性肺切除、胸膜转移灶切除、心包转移灶切除、胸膜微小转移灶电灼及纵隔淋巴结清扫，治疗肺癌伴癌性胸水１４ 例。 结果 所有病历均得到随访，已死亡８ 例，仍存活６例，存活期７～３０ 个月。中位生存期１６－５ 个月。所有病例均未见胸水复发，胸闷、呼吸困难、胸痛及上腹痛症状明显缓解。 结论 此术式操作简单、创伤小、术后恢复快而平稳，控制胸水疗效肯定，其术后生存期明显长于仅做姑息性癌灶切除和内科治疗者。

Objective To evaluatethe effectsoflimited pleuro pneumonectomyforbronchogenic carcino ma associated with cancerouspleuraleffusion. Methods From January.1994to Dec ember1997 weperformed limited pulmonarylobectomy wedgeresection oflung,resection ofthe metastases ofthe parietal pleura,visceral pleura ,diaphragmatic pleuraand pericardiac pleura,andelectroincision ofthe micormetastasesoftheaboveposi tion as wellascleaningthe mediastinallymphnodesin14 cases. Results The14 caseswerefollowed upto De cember 1998.Eightpatientsofthem died,theother6 patientssurvived withasurvivalperiod of7 30 months(me diansurvivalperiod 16-5 months).No pleuraleffusionsrecurrence wasseen.The longestsurvivalperiod was30 months.There were no operative mortality and no severe postoperativecomplication.Chestdistress,dyspnea and pain ofchestorabdomen wererelieved. Conclusions This simple method hassuch advantagesas,lesstrau matic,rapid rehabilitation and effective controlofpleuraleffusion.The postoperativesurvivalperiodislongerthan thatofpalliativeoperation and medicaltherapy.The pain caused by parietalpleural metastasiscan berelieved.