Department of thoracic and cardiovascular surgery; Dongfang Hospital; Beijing University of Chinese MedicineShang Xianrong Cao Jianchun,, an
Department of thoracic and cardiovascular surgery; Dongfang Hospital; Beijing University of Chinese Medicine
Shang Xianrong Cao Jianchun,, and by virtue of him, by the way of
The report (Abstract) since the:1998 surgical treatment of 30 cases of lung cancer, 8 cases with biopsy revealed a large tumor size, close to the hilum, bulky tumor or metastatic lymph nodes around the pulmonary vascular invasion, pericardial and invading the left atrial wall that cannot be dissected according to the normal procedure and treatment of hilar vessels, 4 patients with pericardial incision approach pneumonectomy were (3 cases, right lung left lung in 1 cases), right lung lower lobe and left lower lobectomy in 2 cases. Intrapericardial ligation of pulmonary resection rate was 26.66% (8 / 30). 6 cases of male, female, aged 45-73 years, with an average age of 56 + / - 4.4 years old, in all of the 8 cases. Pathology: 6 cases of squamous cell carcinoma, undifferentiated small cell carcinoma in 2 cases. TNM staging: T3N1M0 3 cases, T2N2M0 in 2 cases, T3N2M0 in 2 cases, T4N2MO in 1 cases. 8 cases were treated with different combinations. Results: there was no early postoperative death and bronchial stump leakage. 4 cases of pneumonectomy were properly maintained in the same amount of fluid to maintain bilateral pleural pressure balance, recovery was satisfactory. The removal of pulmonary vein by pericardial ligation is a new approach to the treatment of the central massive lung cancer in the past. The technical requirements: 1. To prevent the ligature loss caused by fatal bleeding; as intrapericardial ligation vein to prevent false sad real wall; the resection of the tumor of pericardium and left atrial wall can, atrial wall slip continuous 4-0 suture, prevent thrombosis and cancer cell line proliferation of blood. The author believes that the key to improve the overall effect after operation is the operation quality, namely the complete resection of the tumor at the same time, the maximum removal of visible lymph nodes, to achieve complete resection of lung cancer; second is after the body needs certain immune function recovery time, auxiliary chemotherapy were premature after operation; third is to pay attention to psychiatric patients, establish the confidence to overcome cancer.