肺癌心包内处理血管的全肺切除手术59例

Treatment of lung cancer with intrapericardial pneumonectomy (Analysis of 59 cases)

目的 探讨心包内处理血管的全肺切除术在提高肺癌手术疗效中的作用。方法 对 5 9例肺癌病人行心包内处理血管的全肺切除术 ,此术式占同期全肺切除术 41 8% (5 9/141例 )。结果 手术死亡 2例 (3 4% ) ,主要并发症 13 6 %。 1、3、5年生存率分别为 :86 0 % (4 9/5 7例 ) ,31 6 % (18/5 7例 )和2 6 3% (15 /5 7例 )。 3例小细胞肺癌无 1例生存逾 3年。死亡率和并发症发生率与标准全肺切除术相比差异无显著性 ,预后与标准全肺切除术亦相近。结论 心包内处理血管的全肺切除是安全的 ,可提高肺癌切除率 ,改善生活质量 ,提高 5年生存率。

Objective: to review the surgical experience of intrapericardial pneumonectomy for lung cancer. Methods: 59 patients with lung cancer received intrapericardial pneumonectomy. Results: Intrapericardial pneumonectomy was done in 41 8% of all pnermonectomies for lung cancer during 1958 to 2000. The operative mortality rate was 3 4%; the morbidity rate was 13 6%. 1 , 3 and 5 year survival rates were 86 0%, 31 6% and 26 3%, respectively. None of three patients with small cell carcinoma survived more than three years. There was no significant difference in mortality and morbidity rate between intrapericardial pneumonectomy and the routine pneumonectomy (P>0 05). The prognoses were similar in both group, but they were better than exploration group. Conclusion: Intrapericardial pneumonectomy improves the resectability rate, the quality of life and 5 year survival rate.