The Radical Surgical Treatment Effects For T4Lung Cancer(T₄N_0-2M₀) Involving The Superior Vena Cava

Objective:Summary and analysis the effect of surgical treatment for locally advanced non-small cell lung cancer that involving the superior vena cavaMethod:A retrospective research of our department from March2007to May2013period for32cases of locally advanced [T (T4N0M0, T4N1M0, T4N2Mo)] patients with superior vena cava (28males and4females,Age43to72years, median age56years)on non-small cell lung involvement).the surgey were on the side wall of the vena cava resection in25cases, graft replacement in7cases, one case in which the right upper lobectomy, right pneumonectomy in10cases, right upper lung sleeve resection21cases, thoracic duct ligation14cases; pulmonary artery plasty in9cases.Result:1) The group of32patients,5cases of patients turned out arrhythmia during hospitalization (3cases for temporary atrial arrhythmia,1case for temporary Ventricular arrhythmias,1case for heart failure),4cases of patients turned out Lung infection,1case of patients turned out chylothorax,1case of patient was dead,1case of patient had thromboembolism, no patient had bronchial fistula, or anastomotic bleeding,11patients was on tracheotomy,(4were precautionary tracheotomy surgery),1patients died, due to a serious lung infection after discharge, eventually leading to heart failure, respiratory failure and death within a week. Chylous thoracic surgery patients with thoracic duct ligation was not, after conservative treatment,31patients with stable discharge, Improvement of clinical symptoms.2) Pathological type by surgery:22cases of squamous cell carcinoma, adenocarcinoma in10cases. The median survival time of squamous cell carcinoma:17.00months, the median survival time of adenocarcinoma;11.00months, Postoperative pTNM stage:T4NoM09cases, T4N1M04cases. T4N2M019cases.8patients were lost,22patients were followed up for6months to5years, with a median survival time of12.45months;3) To the end of follow-up in patients with no tumor recurrence,3patients tumor metastasis elsewhere, and-found that after the transfer of patients after chemotherapy or radiotherapy were transferredConclusions:1)T4of the superior vena cava involvement of local non-small cell lung cancer patients the chance of serious complications is not high, the clinical symptoms of patients improved significantly.2) Involving the superior vena cava in patients with locally advanced lung cancer surgery extended resection can achieve the purpose of local radical, the clinical efficacy and survival is superior to medical therapy, Many patients were not only recently efficacy, long-term results were better. Therefore, in patients with locally advanced non-small cell lung cancer after radical surgery uses can improve the quality of life and prolong survival period.