Surgical treatment of early hilar lung cancer with special emphasis on limited bronchial resection with and without pulmonary resection.

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• Surgical outcomes of early hilar lung cancers treated in our surgical department were analyzed. The definition of early hilar lung cancer was:(1) the lesion was located proximal to the segmental bronchus, (2) the tumor invasion was confined within the bronchial wall with no invasion into the lung parenchyma, (3) no regional lymphnode metastasis or hematogenous distant metastasis.<BR>Since 1977 when the first patient of early hilar lung cancer was found in our department, to date, there were 20 patients of early hilar lung cancer which corresponded to 3.3% of 603 resected lung cancers during that time. The cell types of all thesepatients were squamous cell carcinoma. Five patients underwent standard lobectomy because the lesions were localized within the segmental bronchus. Twelve patientunderwent standard sleeve lobectomy after combined resection of the main bronchus. For three other patients, limited bronchial resections were attempted. Two of them which hada polypoid tumor at the orifice of segmental bronchus underwent sleeve segmentectomyof S6 of the right lung and S6 of the left lung, respectively. The other patient had a minute squamous cell carcinoma which occupied the bifurcafion of the left upper and lowerlobe bronchi. In this patient double-barreled anatstomosis between the left main bronchus and the double ends of the left upper and lower bronchi was carried out. There wasno operative morbidity or mortality in all patients. The five-year and ten-year survival rates ofthese 20 patients were 100% and 88%, resepectively. Two out of the 20 patients developed second primary cancer in the opposite lung, one of which was a synchronous lesion and the other a metachronous one. The synchronous lesion which was a tiny "in situ" carcinoma in an aged patient was cauterized by a YAG-Laser beam after right upper sleeve lobectomy. Bilateral sleeve lobectomies were performed for the patient with metachronous early hilar lung cancer which developed five years later.<BR>It was concluded that minimal pulmonary and bronchial resection should be attempted in the surgical treatment of early hilar lung cancer.

• 特定非営利活動法人 日本肺癌学会の論文

特定非営利活動法人 日本肺癌学会 | 論文

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