肺切除合并心脏大血管切除重建治疗局部晚期肺癌

目的 总结349例肺切除合并心脏大血管切除重建术治疗局部晚期肺癌的临床疗效。方法 1983年2月－2000年12月，对349例肺癌患者施行肺切除合并心脏大血管切除重建术。肺切除合并肺动脉切除重建术205例；合并部分左心房切除重建术75例；合并上腔静脉切除重建术65例，其中3例同时合并隆凸切除重建术；合并胸主动脉切除重建术4例。结果 本组手术死亡2例，死亡率为0．6％。发生手术并发症53例次，发生率为15．2％。术后1、3、5和10年生存率分别为79．36％、59．93％、33．14％和23．56％。结论 肺切除合并受肺癌侵犯的心脏大血管切除重建术能明显提高患者的生存率，改善患者预后。

Lobectomy or pneumonectomy combined with extended resection of the heart, great vessels in the treatment of locally advanced lung cancer

Objective To summarize the results of extended resection of the heart, great vessels, or both in the treatment of 349 patients with locally advanced lung cancer. Methods From February, 1983 to December, 2000, lobectomy or pneumonectomy combined with extended resection of the heart, great vessels or both were carried out in 349 patients with locally advanced lung cancer. The operations included bronchoplastic procedures and pulmonary artery reconstruction in 205 cases, extended resection of left atrium in 75 cases, superior vena cava resection and reconstruction in 65 cases (3 patients had carina resection and reconstruction simultaneously), and aorta resection and reconstruction in 4 cases respectively. Results There were two operative death. The operative mortality was 0.6% in the series. Fifty three patients had operative complications. The 1,3,5 and 10 year survival rates were 79.36%, 59.93%, 33.14% and 23.56% respectively. Conclusion Extended resection of the heart, great vessels or both can remarkably increase the long term survival and improve the prognosis in patients with locally advanced lung cancer.