Clinical analysis of completion pneumonectomy on lung cancer

Abstract

目的 探讨余肺切除治疗肺癌的手术适应症、手术技巧及预后。方法 32 例肺癌行余肺切除,采用Kaplan-Meier 法计算5 年生存率, 与同期165 例标准全肺切除肺癌5 年生存率比较(χ2检验) 。结果 全组无手术死亡病例, 7 例( 21. 9%) 术后出现并发症, 5 年生存率为21. 9%, 与同期标准全肺切除肺癌25. 7%的5年生存率比较无显著性差异( P > 0. 05) 。结论 余肺切除治疗肺癌的适应症包括复发性肺癌、二次原发肺癌及良性病变肺切除后原发肺癌。尽管余肺切除手术操作复杂, 但其5 年生存率可达到标准全肺切除的水平。

Objective To explore the indications, operative technique and outcome of completion pneumonectomy for lung cancer . Methods Thirty-two cases of lung cancer underwent completion pneumonectomy. The 5-year survival rate was calculated with a Kaplan-Meier model and compared with that of the 165 standard pneumonectomy on lung cancer during the same period. Results Extrapleural dissection was performed in 8 cases, intrapericardial vessel ligation was in 16, chest wall was resected in 1, and the left atrium was partly resected in 1. There was no operative mortality. The postoperative complication incidence was 21. 9% ( 7/ 32) , which was significantly higher than that for standard pneumonectomy ( 5. 5%, 9/ 165) during the same period ( P 0. 05) . Conclusion The indications for completion pneumonectomy include local recurrence, second primary lung cancer and lung cancer developed after pneumonectomy for benign disease. Although the operative technique is complex and the postoperative complication incidence is high, the 5-year survival rate can be the same as that of standard pneumonectomy.