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目的总结气管、隆凸主支气管肿瘤手术治疗经验,探讨合理的手术方法及治疗措施。方法回顾性分析我院在1996年1月至2004年6月期间,手术治疗的27例气管、隆凸主支气管肿瘤患者的临床资料。27例中,鳞癌15例,腺癌3例,其余9例为良性腺瘤、腺样囊腺癌和类癌。结果气管肿瘤切除+端端吻合8例；全肺隆凸切除+气管与主支气管端端吻合9例(右6例,左3例)；右上肺隆凸袖式切除重建术2例；隆凸切除重建术3例；气管肿瘤及气管壁部分切除5例,其中体外循环辅助下手术2例。术后早期死亡3例,其中2例死于多器官衰竭,1例系因胸腔感染、出血死亡。半年以上随访24例,无死亡,无外科并发症。结论隆凸及气管手术比较复杂,难度大,应选择合理的术式及麻醉方法,必要时应用体外循环辅助,可以取得满意疗效。
Objective To summarize the experience of tracheal and maxillary main bronchial tumor surgery and to explore reasonable surgical methods and treatment measures. Methods The clinical data of 27 patients with tracheobronchial main bronchogenic carcinoma treated surgically from January 1996 to June 2004 in our hospital were retrospectively analyzed. Among the 27 cases, 15 were squamous cell carcinoma, 3 adenocarcinoma, and the remaining 9 were benign adenoma, adenoid cystadenocarcinoma and carcinoid. Results There were 8 cases of resection of the trachea tumor + end-to-end anastomosis; 9 cases (6 cases in the right and 3 cases in the left) anastomosed by pneumothorax resection + tracheal endotracheal tube endotracheal intubation; Resection and reconstruction in 3 cases; tracheal tumor and tracheal wall partial resection in 5 cases, of which surgery assisted by cardiopulmonary bypass in 2 cases. There were 3 early deaths after operation, of which 2 died of multiple organ failure and 1 died of bleeding due to thoracic infection. More than six months followed up 24 cases, no death, no surgical complications. Conclusions Condyle and tracheal surgery is more complicated and difficult, and a reasonable method of operation and anesthesia should be selected. If necessary, CPB should be used to obtain satisfactory results.