摘要
肺癌是导致中国癌症死因的首位。完全性切除是目前治疗肺癌的最好方法。但是 ,仅有约三分之一的肺癌适合于外科治疗 ,另三分之二的肺癌由于伴有远处转移或侵犯邻近器官而被视为不可手术。近年来 ,随着心血管外科理论和技术在肺癌外科中的应用 ,使得肺切除合并受侵的左心房、胸主动脉、上腔静脉和肺动脉的整块切除成为可能。这些过去被视为外科禁忌症和无治愈希望的局部晚期肺癌 ,不但获得肿瘤完全切除、无肿瘤复发转移 ,而且获得长期生存和良好的生活质量。本文将对局部晚期肺癌外科治疗理论和技术进展作一简要介绍。此外 ,对局部晚期肺癌外科治疗指征、方法 ,结果和多学科综合治疗 ,包括上腔静脉、左心房、胸主动脉和肺主动脉扩大切除重建 ,进行介绍。最后 ,对局部晚期肺癌扩大切除术的围术期处理加以讨论。
Lung cancer causes the highest number of cancer-related death in China. Complete surgical resection is currently the best treatment modality for lung cancer. However, only one third of patients with lung cancer can be identified as candidates for operation. The other two thirds are inoperable, because they have late disease with distant metastasis or locally advanced lung cancer involving neighboring organs. Recently introduction of the theory and technique of cardiovascular surgery into lung cancer surgery has made possible en bloc resection of the lung combined with part of the involved left atrium, aorta, superior vena cava, and pulmonary artery. It has made possible for the patients with locally advanced lung cancer, who were thought as surgical contraindication or incurable cases, to not only have complete resection of the tumor, but also achieved long term survival and good life quality without evidence of recurrence and distant metastasis of the cancer.This paper will provide a brief background at the progression of surgical theory and technology of locally advanced lung cancer in China. Besides, the indication, present methods, results of surgical management and multimodality treatment for locally advanced lung cancer, including extended resection and reconstruction of superior vena cava, left atrium, aorta and pulmonary artery will be presented. Finally, the perioperative management for the extended resection of locally advanced lung cancer will also be discussed.
出处
《中国癌症杂志》
CAS
CSCD
2003年第5期411-415,共5页
China Oncology
关键词
局部晚期肺癌
扩大切除术
手术指征
围术期处理
locally advanced lung cancer
extended resection indication
perioperative management
