肺癌心包内结扎血管的全肺切除术32例

Treatment of lung cancer with intrap ericardial pneumonectomy (Analysis of 32cases)

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32例肺癌病人行心包处理血管的全肺切除术进行回顾性总结,此术式占同期全肺切除术42.1%(32/76例)。结果手术死亡率为0%,主要并发症18.7%,1、3、5年生存率分别为:87.5%(28/32例),34.3%(11/32例)和28.1%(9/32例)。5例小细胞肺癌无1例生存逾3年。死亡率和并发症与标准全肺切除术相比差异无显著性(P>0.05),预后与标准全肺切除术亦相近。结论心包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,在临床上有实用价值。

Object iv e:To review the surgical experience of intrapericardial pneumonectomy fo r lung cancer.Methods:32pa-tients with lung cancer received int rapercardial pneu monectomy intrap ericardial pneuminectomy was done i n 42.1%of all pnemonec tomies for lung cancer during 1986to 2000.Results:The operative mortal ity rate was zero;the morbidity rate was18.7%.1-,3-,and 5-year su rvival ra tes were 87.5%,34.3%and 28.7%,None of five patients w ith small cell carc inoma survived more than three years.There was no signfica nt difference in mortality and morbidity rate between in trapericardial pneu-mo nectomy and the routine pneumonec tomy (P>0.05).The prognoses were simil ar in both g roup,but they were better than ex-ploration group.Conlusin:Intr apericardial pneumonectomy im proves the resectability rate,the q uality of lif t and 5-year survival rate.