Evaluation of the Use of Cardiopulmonary Bypass in the Surgical Treatment of Lung Cancer

概要

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Among 35 patients with lung cancer who received combined resection of the lung and the involved portion of the heart or the great vessels having been invaded by direct extension of the primary tumor, five patients had too extensive disease for adequate marginal removal by conventional cross-clamp exclusion. We used cardiopulmonary bypass (C-P bypass) for those five patients to resect and reconstruct the involved portion of the heart or the great vessels. The resected organs were the intrapericardial portion of the pulmonary artery, the left atrium or the aortic wall. In three patients two mediastinal organs were resected and in two patients three mediastinal organs were resected. In 4 patients the surgical margins of the resection were clear of tumor. For patients with the tumor in the right lung the standard left lateral position was used and for patients with the tumor in the left lung the right semilateral position was preferred. We applied the pump-oxygenator and lung resection for both patients. It took a long time and the amount of blood loss was not small in the patients whom C-P bypass was applied. All five patients died within two years. But three of them could return to their previous jobs. Efforts to minimize the operative mortality and morbidity are needed and more effective modes of combined therapy would be needed to improve the patient's survival.
北里大学の論文
1993-12-31