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目的:总结气管原发性肿瘤外科治疗经验,探讨治疗效果及影响因素。方法:总结2007年5月-2009年1月收治的13例行外科治疗的气管原发性肿瘤患者临床资料,分析疗效及影响因素。病理学包括腺样囊性癌8例,黏液表皮样癌2例,上皮-肌上皮癌2例,鳞状细胞癌1例。结果:10例气管肿瘤患者经右胸后外侧切口完成手术,其中8例行气管袖状切除加端-端吻合术,1例行袖式右全肺切除加左主支气管-气管端-端吻合术,1例行隆突切除-隆突重建。另有1例经颈部衣领切口、2例经胸骨正中切口完成手术,均为一期切除后重建。鳞状细胞癌患者有1枚淋巴结转移,其余患者淋巴结均为阴性。2例患者术后出现左侧喉返神经麻痹,无其他术后早期并发症发生,术后住院时间平均(9.7±0.5)d。平均随访(6.8±2.1)个月,无肿瘤复发。结论:手术切除是治疗气管原发性肿瘤的有效方法,病理类型及切除范围对患者术后远期生存率有很大影响。
Objective: To summarize the experience of surgical treatment of tracheal primary tumors and to explore the therapeutic effect and influencing factors. Methods: The clinical data of 13 patients with tracheal primary tumor treated from May 2007 to January 2009 were summarized, and the curative effect and influencing factors were analyzed. Pathology, including adenoid cystic carcinoma in 8 cases, mucoepidermoid carcinoma in 2 cases, epithelial-myoepithelial carcinoma in 2 cases, squamous cell carcinoma in 1 case. Results: Thirteen patients with tracheal tumor underwent surgery through lateral posterolateral thoracotomy, including 8 cases of tracheal sleeve resection plus end-to-end anastomosis and 1 case of right pneumonectomy combined with left main bronchus-trachea end-to-end anastomosis Surgery, 1 case of protuberance excision - reconstruction of the carina. Another case of neck collar incision, 2 cases of the middle of the sternotomy surgery, are a resection and reconstruction. Squamous cell carcinoma patients had a lymph node metastasis, the remaining patients were negative lymph nodes. Two patients had left recurrent laryngeal nerve paralysis after operation, and no other early postoperative complications occurred. The average postoperative hospital stay was (9.7 ± 0.5) d. The average follow-up (6.8 ± 2.1) months, no tumor recurrence. Conclusion: Surgical resection is an effective method for the treatment of primary tracheal tumor. The pathological types and resection range have a great influence on the postoperative long-term survival rate of patients.