高频电刀在肺癌根治术中的应用(附58例报告)

Application of High frequency Electroscalpel in Lung Carcinoma Resection

目的 研究在肺癌手术中应用高频电刀对肺癌淋巴结转移和癌组织侵及大血管、气管、支气管造成不可根治性切除的残留,进行热灼处理,达到使肿瘤环死的目的,了解热灼后组织学改变,观察远期疗效。方法 采用美国产Ⅱ型高频电刀,对58例中晚期肺癌,手术中有肺门、纵隔淋巴结转移者,胸膜有播散种植转移者,以及大血管受侵、气管支气管受侵者,残留不可切除的,实行高频电刀热灼处理,使残留癌组织凝固坏死,达到治疗目的。结果 术后经病理证实在淋巴结清除过程中有残留者36例,占62％(36/58)。术后序贯治疗55例,其中放疗加化疗17例,单纯化疗38例,失访3例。术后超过3年者21例,死亡7例,失访2例。术后超过2年者30例,死亡6例,失访1例,术后18～24个月者7例均建在。术后随访55例,两年生存(35/55)63.6％。结论 对残留的癌组织施行高频电刀热灼处理,在一定程度上达到了相对根治切除的目的,延长了病人的生存期。

Objective To study the application of high frequency electroscalpel in advanced lung carcinoma resection. To evalute the long term effect. Methods Fifty-eight patients were performed by electrogenerator Ⅱ, which were incomplete resection. Results Postoperative 36 patients whose mediastinal lymph nodes incompletely resected were conformed by pathological evidence, which were 62% (36/ 58). Postoperative 55 patients, chemotherapy and radiotherapy 17 patients, chemotherapy 38 patients. Two year survival rate is 63.6% (35/55). Conclusion Using high frequency electroscalpel to electrocoagulate remaining carcinoma tissues, to some extent, which reached the aim of relative resection. This method increase the survival time of Lung carcinoma patients.