经心包内全肺切除治疗中央型肺癌40例分析

Analysis of pneumonectomy via intrapericardial vascular management in the treatment of central lung cancer （a report of 40 cases）

目的 总结全肺切除术治疗中央型肺癌的临床经验,探讨经心包内全肺切除的治疗价值.方法 2003年-2005年 行心包内全肺切除40例（部分左心房切除5例）;鳞癌17例,腺癌8例,腺鳞癌5例,小细胞未分化癌10例;常规进行系统淋巴结清扫.结果 本组无围手术期死亡病例,术后1年、3年、5年生存率分别为65.0%（26/40）、37.5%（15/40）、17.5%（7/40）,其中4例生存超过6年.结论 经心包内全肺及部分左心房切除术可提高中央型肺癌根治性手术的切除率,降低术中大出血的风险性.

Objective To summarize the clinical experience in 40 cases of central lung cancer undergoing total pneumonectomy and to investigate the therapeutic value of total pneumonectomy via intrapericardial vascular management in the treatment Of central lung cancer. Methods From January 2003 to December 2005, 40 patients with central lung cancer were surgically treated with total pneumonectomy via intrapericardial vascular management （combined with partial resection of left atrium in 5 cases） in our hospital. There were 17 cases of squamous cell carcinoma, 8 cases of adnoearcinoma, 5 cases of adenosquamous carcinoma and 10 cases of smallcell undifferentiated carcinoma; and systematic lymph node dissection was performed. Results There was no perioperative death. The survival rate of 1, 3 and 5 years after surgery was 65.0%, 37.5% and 17.5%, respectively, of which 4 case survived for over 6 years. Conclusion Total pneumonectomy via intrapericardial vascular management combined with partial resection of left atrium could increase the resection rate in the radical surgery for central lung cancer and decrease the risk of intraoperative hemorrhage.