The experience of surgical resection in 1964 cases of primary bronchogenic carcinoma

Abstract

To summarize the experience of surgical resection of primary bronchogenic carcinoma (PBC) . We reviewed the clinicopathologic data of 1 964 cases of PBC. There were 1 140 central type and 824 peripheral type. Among them, 1 626 cases ( 82. 8%, 1 626/ 1 964) were given successive resection, in which 160 cases were total pneumonectomy, 1 386 cases were lobectomy, 70 cases were sleeve lobectomy, and 10 cases were wedge resection. Two hundred and ninety2four cases had various postoperative complications and 20 cases died. The operative mortality was 1. 0%( 20/ 1 964) . Managements of problems encountered in operation were discussed in this paper. Surgical resection is a better apporach in the treatment of PBC. Left upper lung cancer invading and surrounding the pulmonary artery trunk requires blocking the pulmonary artery root first, then separating the invaded blood vessels and resecting the tumor and upper pulmonary lobe, lastly dealing with the remained cancer tissues. For patients with intermediate and advanced lung cancer, if the root of pulmonary artery and vein almost attaches to the tumor, intrapericardial blood vessels ligation should be performed. When the right upper lung cancer invades and surrounds the superior vena cava and the upper pulmonary artery trunk, we should cut and ligate the azygos vein first and draw the superior vena cava gently towards front outside and dissect carefully. If the tumor, hilar, mediastinal and associated lymph nodesmix together to formthe frozen hilar, we should deal with the main bronchus first, then the pulmonary artery and vein.