CAJ | 학술논문

目的：探讨肺癌开胸后不能手术切除的原因，提高手术切除率。方法回顾性分析该院2005～2012年28例开胸后不能切除肺癌患者的临床资料，着重对术中情况与术前胸片、CT检查进行对比分析。结果该院2005～2012年的开胸探查率约为4．8％（28/583）；手术无法切除原因为：胸腔内多发转移；肿瘤、转移淋巴结侵犯肺门组织或纵隔内大血管；因肺功能受限不能耐受扩大切除术及全肺切除术。结论术前准确临床分期有助于减少开胸探查率，胸部 CT结合 X线片检查对判断肿瘤胸腔转移、肿瘤与纵隔结构的关系及决定是否手术有重要指导意义，胸腔镜及PET-CT扫描能有效减少开胸探查率。
목적：탐토폐암개흉후불능수술절제적원인，제고수술절제솔。방법회고성분석해원2005～2012년28례개흉후불능절제폐암환자적림상자료，착중대술중정황여술전흉편、CT검사진행대비분석。결과해원2005～2012년적개흉탐사솔약위4．8％（28/583）；수술무법절제원인위：흉강내다발전이；종류、전이림파결침범폐문조직혹종격내대혈관；인폐공능수한불능내수확대절제술급전폐절제술。결론술전준학림상분기유조우감소개흉탐사솔，흉부 CT결합 X선편검사대판단종류흉강전이、종류여종격결구적관계급결정시부수술유중요지도의의，흉강경급PET-CT소묘능유효감소개흉탐사솔。
Objective To investigate the reason of inoperableness after explore thoracic cavity and improve resection rate.Meth-ods Retrospective analysed 28 cases clinical data of lung cancer patients which were inoperable after explore thoracic cavity since 2005 to 2012.Contrastive analysed intraoperative condition with X-ray photographs and CT examination on chest preoperative em-phatically.Investigate the reason of inoperableness after explore thoracic cavity and countermeasure.Results The rate of explorato-ry thoracotomy was 4.8%(28/583)since 2005 to 2012.The reason of inoperableness was multiple metastasize in thoracic cavity;tumor or metastatic lymph nodes encroach on hilum of lung or great vessels in mediastinum;unable to endure expand ectomy or to-tal pneumonectomy for pulmonary function limiting.Conclusion Exact divide clinical stage befor operating could conduce to de-crease the rate of exploratory thoracotomy.The X-ray photographs and CT examination on chest is important to j udge the neoplasm metastasis in thoracic cavity and the relationship between tumor and mediastinum and decide whether or not to operate.Thoraco-scope and PET-CT examination could decrease the rate of exploratory thoracotomy effectively.