预防性心包内肺循环短暂阻断术在局限性T4期肺癌外科治疗中的应用

目的 探讨预防性心包内肺循环短暂阻断术在局限性T4期肺癌外科治疗中的应用价值.方法 开胸后探查肺癌、转移淋巴结与肺血管的关系,切开心包,在心包内游离患侧肺动脉根部和肺上、下静脉,通过肺循环短暂阻断术结合成形术完成肺癌切除.结果 肺动脉阻断时间为(22±4) min,肺静脉阻断时间为(18±3) min,术中出血量为(239±71) ml.24例患者均成功实施肺癌切除,未行全肺切除术.术中无死亡病例,术后无严重并发症.结论 预防性心包内肺循环短暂性阻断术能提高T4期肺癌手术的安全性和肿瘤切除的彻底性,减少全肺切除的施行.

Prophylactic transient blocking of intrapericardial pulmonary circulation for surgical treatment of stage IV central lung cancer

Objective To investigate the feasibility of prophylactic transient blocking of intrapericardial pulmonary circulation for surgical treatment of central lung cancer with stage IV to preserve the normal pulmonary functinon.Methods The relation of the pulmonary vessels,the lung neoplasm and the enlarged mediastinal lymph nodes were investigated.The pericardium was opened and the pulmonary artery,the upper and lower lobe pulmonary veins were dissected.Those three vessels were blocked.When the pulmonary circulation was stopped,bloodless lobectomy and pulmonary artery anastomosis were performed.Then the blockers were released,and pulmonary circulation was restored.Results The time of blocking of pulmonary artery and veins were（22±4） min and（18±3） min,respectively.The amount of bleeding in the operation was（239±71） ml.All of the 24 patients were received complete resection of the tumor,and the normal functioning pulmonary tissue was preserved instead of pneumonectomy.There were no cases of death in the surgery,and there were no serious complication after operation.Conclusion The use of prophylactic transient blocking of intrapericardial pulmonary circulation can improve the safety of operation,achieve complete resection and decrease the application of pneumonectomy for central lung cancer with stage IV.