肺癌切除术后余肺切除

Completion Pneumonectomy for Patie nts after Resection of Lung Cancer

目的:探讨肺癌余肺切除的手术特点及风险。方法:对16例肺癌术后余肺切除患者的临床资料进行回顾性分析。结果:本组患者的根治性切除率、手术并发症发生率及手术死亡率分别为813%、313%和0%。平均手术出血量12233ml。心包内结扎血管患者占50%。总的1、3、5年生存率分别为878%、546%和400%。结论:由于首次手术或术后放、化疗导致的胸膜腔广泛粘连,肺癌术后余肺切除在技术上难度较大,但只要合理选择指征,对术中可能遇到的困难有充分估计,注意手术操作每个细节,则可以降低手术风险,达到延长患者生存期的目的。

Objective：To evalua te the risk and characteris tic of completion pneumonectomy aft er resection of lung cancer．Method：The clinical data of １６patients with completion pneumonec tomy after resection of lung cancer were analyzed retrospectively．Results：The radical resectability，morbidi ty，and mortality were ８１．３％，３１．３％a nd ０．０％．The mean operative blood loss was １２２３．３ml．T he percentage of patients with intra pericardial dissection was ５０．０％．T he １year，３year a nd ５year survival rates were ８７．８％，５４．６％and ４０．０％．Conclusion： Because of the extensive adhesion after first operation，radiotherapy and ／or c hemotherapy，the completion pneumonectomy after resection of lung cancer was dif ficult，but if operation indication is appropriate and surgical technique is co nsid ered carefully during operation，co mpletion pneumonectomy can prolong the patie nts survival time and its operative r isk can be decreased．