复杂手术技术在非小细胞肺癌治疗中的临床应用

Clinical application of complex surgical techniques in the treatment of lung cancer

肺癌是我国乃至全球发病率和死亡率最高的恶性肿瘤。目前,非小细胞肺癌的治疗方式仍是以手术为主的综合治疗。靠近肺门的中央型肺癌,常需要行支气管和(或)血管成形的袖状肺叶切除术。对于侵犯临近器官的局部晚期肺癌,需要切除原发肿瘤及其相邻器官,同时加以修复、重建或置换。近年来,新辅助免疫治疗通过诱导机体对于肺癌的免疫效应,在肿瘤及淋巴结术前降期上发挥着巨大作用,并给患者带来长久的生存获益。该文结合相关文献,对复杂手术的分类、切口选择及技术要点做出总结,并通过作者自身多年的临床经验,提出了心得体会,以供广大中青年胸外科医师参考,希望借此让更多的肺癌患者从中获益。

Lung cancer is the malignant tumor with the highest morbidity and mortality in China and even in the world.At present,the treatment of non-small cell lung cancer is still surgery-based comprehensive treatment.Central lung cancer near the hilum often requires sleeve lobectomy with bronchoplasty and/or angioplasty.For locally advanced lung cancer invading adjacent organs,the primary tumor and its adjacent organs need to be removed,repaired,reconstructed or replaced at the same time.In recent years,neoadjuvant immunotherapy plays an important role in the preoperative descending period of tumor and lymph node by inducing the immune effect of lung cancer,and brings long-term survival benefits to patients.Combined with the current relevant literature,the author summarizes the classification,incision selection and technical points of complex surgery,and puts forward his own experience through many years of clinical experience,which can be used as a reference for the majority of young and middle-aged thoracic surgeons.We hope to benefit more patients with lung cancer.