论文部分内容阅读
自从Eisclsberg1922年第一次提出手术切除治疗恶性胸膜间皮瘤可能有效后,这方面的文献很多。早期的结果很悲观,因手术死亡率高,比不手术病人在寿命上无明显延长。在过去15年我们有外科治疗52例恶性胸膜间皮瘤的经验,33例行胸膜外全肺切除,常附加部份或全部的膈肌切除。19例仅行胸膜切除,总手术死亡率为13%(7例,全肺切除为3/33,胸膜切除为4/19) 术后存活的中期数二组均为13个月左右,大部份病人术后加放疗或/和化疗,最显著的姑息疗效为缓解胸水的生成。说明手术适应症及操作过程细节。
Since Eisclsberg’s first surgical resection in 1922 to treat malignant pleural mesothelioma may be effective, there are many literatures in this area. The early results were pessimistic because of the high mortality rate of surgery and no significant extension of life expectancy compared with non-surgical patients. In the past 15 years, we have had the experience of surgical treatment of 52 cases of malignant pleural mesothelioma. 33 cases underwent extrapulmonary pneumonectomy, often with some or all of the diaphragmatic resection. In 19 cases, only pleural resection was performed. The total surgical mortality was 13% (7 cases, pneumonectomy 3/33, and pleural excision 4/19). The median survival rate in the second group was 13 months or so. After the patient was treated with radiotherapy or/and chemotherapy, the most significant palliative effect was to relieve the formation of pleural effusion. Explain the surgical indications and details of the procedure.