10例原发性气管肿瘤的外科诊断及手术治疗

Surgical diagnosis and operative treatment of primary tracheal tumor in 10 cases

目的总结外科手术治疗原发性气管肿瘤的临床经验。方法回顾分析本院1993年10月～2010年1月收治的10例气管肿瘤的诊断和治疗经验。结果本组鳞癌3例,腺癌3例,腺鳞癌1例,良性肿瘤3例;临床治愈9例,术后3 d死亡1例。本组3例鳞癌患者分别于手术后3年和8个月复发死亡;3例腺癌,1例术后1年出现肺转移,另2例存活10个月。结论手术切除是治疗气管肿瘤最有效的方法:(1)纤维支气管镜检查与多排CT增强三维成像对确定气管肿瘤范围有互补作用;(2)充分的术前呼吸道准备,是术中安全、术后顺利康复的保障;(3)手术者和麻醉医师密切配合,选择视野较宽的纤维支气管镜引导气管插管是麻醉安全的重要保障。

Objective To summarize the clinical experience of surgical treatment on primary tracheal tumors. Methods A retrospective analysis was made in the diagnosis and treatment experience of 10 patients with tracheal tumor admitted in our hospital from October 1993 to January 2010. Results There were 3 cases of squamous cell carcinoma, 3 cases of adenocarcinoma, 1 case of adenosquamous carcinoma, and 3 cases of benign tumor. Nine ones were clinically cured. One case was dead 3 d after the operation. In 3 cases of squamous cell carcinoma, patients died because of recurrence respectively 3 y and 8 months after the operation. In other 3 cases of adenocarcinoma, postoperative pulmonary metastasis occurred in 1 case 1 y after the operation, and the other 2 patients survived for 10 months. Conclusion Exairesis is the most effective treatment on tracheal tumors. （ 1 ） Fiberoptic bronchoscopy and multi three - dimensional CT imaging have supplementary effect on determining the range of tracheal tumor;（2）Sulticient preoperative preparation of respiratory tract can ensure the safety during the operation and the successful postoperative recovery ; （3） The operator and anesthesia physicians can ensure the safety of anesthesia by cooperating closely in the selection of bronchofibroscope with a wide view to guide the tracheal intubation.