폐암의 "Complex Pneumonectomy"

Abstract

The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, peri- cardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy" From March 1990 to February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial re- section, and one patient had resection of diaphragm Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years) with male to female ratio of 17 to 1. The chief complaints of the patients on admission were cough (13), dyspnea on exertion (11), chest pain (10), weight loss (9), general fatigue (9), and sputum production (4 . Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3NO MO, 4 TIWIMO, 6 T3N2MO, 5 T4N2MO, and 1 TIWIMO. There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07 ± 4.82 months. One patient with stage TINOMO who had chest wall resection is alive at 35 months follow-up and a patient with T3N2MO who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "complex pneumonec- tomy" is very important, and a long term survival is possible.ong term survival is possible.