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目的 总结外科手术治疗原发性气管肿瘤的临床经验。 方法 回顾性分析我科196 8～ 2 0 0 1年 70例原发性气管肿瘤的外科治疗资料。 结果 气管节段切除 39例 ,隆凸切除 13例 ,气管侧壁切除 10例 ,肿瘤局部剔除 5例 ,全肺切除 1例 ,开胸探查 2例。并发症发生率 31% (2 2 / 70 )。气管切除与重建术后 30d内死亡率 8% (4 / 5 2 )。良性肿瘤 14例 ,恶性肿瘤 5 6例。其中腺样囊性癌和鳞癌是最常见的类型 ,分别为 4 5 % (2 5 / 5 6 )和 2 3% (13/ 5 6 )。良性肿瘤随诊平均 5 7年。恶性肿瘤切除术后 5、10年生存率分别为 6 4 % (2 1/ 33)和 5 4 % (14 / 2 6 )。 结论 手术切除是治疗气管肿瘤最有效的方法。气管节段切除是治疗气管恶性肿瘤的主要术式 ,良性肿瘤可以考虑保守的术式。降低手术并发症是取得良好手术疗效的关键。
Objective To summarize the clinical experience of surgical treatment of primary tracheal tumor. Methods Retrospective analysis of surgical treatment of 70 cases of primary tracheal tumor in our department from 1986 to 2001. Results Thirty-nine patients underwent resection of the trachea segment, 13 underwent carotid resection, 10 underwent resection of the trachea, 5 underwent partial resection of the tumor, 1 underwent pneumonectomy and 2 underwent thoracotomy. The complication rate was 31% (2 2/70). The mortality rate within 30 days after tracheostomy and reconstruction was 8% (4/52). 14 cases of benign tumors, 56 cases of malignant tumors. Among them, adenoid cystic carcinoma and squamous cell carcinoma were the most common types, which were 45% (25/56) and 23% (13/56) respectively. The average follow-up of benign tumors was 57 years. The 5-year and 10-year survival rates after resection of malignant tumors were 64% (21/33) and 54% (14/26), respectively. Conclusion Surgical resection is the most effective way to treat tracheal tumor. Tracheal resection is the main surgical treatment of tracheal malignancies, benign tumors can be considered conservative operation. Reducing surgical complications is the key to good surgical outcomes.