Synchronous primary cancers of trachea and esophagus and ventricular tachycardia

The incidence of multiple primary cancers involving trachea is rare. We present a case of synchronous double primary cancer of trachea and esophagus in a 70-year-old woman, with a special symptom of ventricular tachycardia and no/a/story of smoking and alcohol drinking. Biopsies （tom multiple loci demonstrated the patient had primary small cell cancer of trachea and squamous cell carcinoma in situ of esophagus. The patient was successfully treated with four cycles of chemotherapy consisting of etoposide and earboplatin （EC） followed by thoracic radiotherapy （60 Gy in 30 fractions, in 6 weeks）, and was evaluated to have complete response of tumor. To our knowledge, there is no synchronous cancer of trachea and esophagus has been reported in English literature, and our experience showed sequential EC chemotherapy and radiotherapy provided an effective treatment to control both cancers.

局部晚期非小细胞肺癌外科治疗中的气道重建

背景与目的部分局部晚期非小细胞肺癌患者需要采取不同的气道重建方式,以彻底切除病变并最大限度保存肺功能。本研究旨在探讨气道重建中的外科相关问题。方法回顾分析研究2003年1月～2005年6月2206例肺癌手术中100例气道重建患者的临床资料,其中鳞癌42例,腺鳞癌23例,腺癌11例,粘液表皮样癌5例,腺样囊性癌4例,类癌3例及其它混合散在分布类型12例。ⅠB期34例,ⅡB期23例,ⅢA期23例,ⅢB期20例。主要手术方式包括:右上叶袖状切除42例,右下叶袖状切除1例,左上叶袖状切除24例,左下叶袖状切除4例,两叶袖状切除8例,隆凸成形重建17例,肺叶袖状切除合并肺动脉成形4例。结果97例患者为完全性切除(R0),3例为不完全性切除(R1)。术后5例出现并发症,分别为肺部感染2例,胸腔感染1例,支气管胸膜瘘1例,肺泡胸膜瘘1例,并发症发生率为5%。术后住院日为4～27日(中位11日)。99例治愈出院,肺部感染导致死亡1例,手术死亡率为1%。结论对局部晚期非小细胞肺癌采取适当的气道重建方式,符合外科手术原则,可取得较满意的治疗效果。对血管、气管、支气管的处理技巧是手术获得成功的关键。