主动脉窗型肺癌的外科治疗(附30例报告)

Surgical treatment of bronchogenic carcinoma located in the aortic window (report of 30 cases)

目的 分析主动脉窗型肺癌的外科治疗效果。方法 1980年 1月～ 1997年 10月外科治疗主动脉窗型肺癌 3 0例。Ⅲa期 2 2例 ,Ⅲb期 8例。剖胸探查 5例 (占 16.67% ) ;全肺切除 16例 (占 5 3 .3 3 % ) ;左上叶支气管成形肺叶切除 9例 (占 3 0 .0 % ) ,含同时行肺动脉成形术 7例 (占 2 3 .3 3 % )。结果 术后 1、3、5年生存率分别为 64 .0 %、2 8.0 %、8.0 %。结论 主动脉窗型肺癌因其特殊的解剖部位 ,导致手术探查率高 ,全肺切除率高。支气管成形及肺动脉成形肺叶切除是首选手术方式 ,术后应配合化疗、放疗及免疫等综合治疗 ,提高其治疗效果。

Objective To evaluate the effects of surgical treatment of bronchogenic carcinoma located in the aortic window.Methods From January 1980 to October 1997,30 cases with bronchogenic carcinoma located in the aortic window underwent surgical treatment.According to TNM classification,22 cases were in stage Ⅲa and 8 cases in stage Ⅲb.The exploratory was performed in 5 cases,the total pneumonectomy in 16 cases.The bronchoplasty was performed in 9 cases and pulmonary arterioplasty in 7 cases at the same time.Results The overall 1 ,3 and 5 year survival rates were 64.0%?28.0%?8.0% respectively.Conclusion Bronchogenic carcinoma located in the aortic window,because of the special anatomical structure,may lead to high rate of the exploratory and total pneumonectomy.Bronchoplasty and pulmonary arterioplasty are the first choice in the treatment of the disease.Chemotherapy,radiotherapy and immunotherapy should be given after operation.