补充性全肺切除术对残肺病变的治疗价值

Completion Pneumonectomy for the Diseases of Residual Lung- A Report of 68 Cases

目的:评估补充性全肺切除术的适应证、危险性和结果。方法:回顾性分析68 例年龄在15 ～71 岁的残肺良恶性病变的患者的补充性全肺切除术,其中第二肺癌17 例,肺复发癌32 例,良性肺及胸膜疾患19 例。再次手术间隔期为恶性者29 个月,良性为217 个月。结果:7 例患者死亡(10 .4 % ) ,2 例死于术中,5 例死于术后,癌性患者死亡率(11 .6 % ) 高于良性患者(5 .9 % ) 。全部病例5 年生存率为48 % ,癌症患者为33 % ,良性疾患为88 % 。结论:补充性全肺切除术可以用于治疗残肺的病变,其手术死亡率接近标准的全肺切除术,而患者在术后获得长时期的生存。

Objective: To study the indication, risk and results of completion pneumonectomy for residual lung diseases. Methods:A retrospective review was made on 68 consecutive patients aged 15-71, and diagnosed as recurrent lung cancer (N=32), primary lung cancer (N=17) and benign pleuro-pulmonary disease (N=19) who underwent completion pneumonectomy. The interval between the first operation and completion pneumonectomy averaged 29 months for carcinoma patients and 217 months for patients with benign diseases. Results: Seven patients died at operation (N=2) or post -operatively (N=5) for an overall operative mortality of 10.4% which was higher in carcinoma patients (11.6%) than that in patients with benign diseases (5.9%). Actuarial 5 year survival rate was 48% for the entire series(33% for cancer patients and 88% for patients with benign diseases). Conclusion: These results suggest that completion pneumonectomy can be done with an operative risk similar to that of standard pneumonectomy (6～10%). And, patients undergone completion pneumonectomy have a reasonable prospect for long-term survival.