关键词: 联合肺叶切除, 纵隔淋巴结廓清, 临床特征, 中叶肺癌

Abstract: To investigate the features of clinical performances and surgical treatments for patients with primary middle lobe lung carcinoma so as to enhance the diagnostic and survival rate. MethodsThe clinical data and therapeutic results of 106 patients with middle lobe lung cancer who had undergone surgical treatment were retrospectively studied. ResultsThere were 62 patients with cough, 48 with bloody sputum, 29 with fever, 16 with chest pains and 8 with joint pains. Thirty patients were subjected to antiinflammatory treatments for more than 30 days and 9 anti-tuberculosis treatments. Sixtyfour cases were diagnosed within 1 month, 25 within 1 to 6 months, 13 within 7 to 12 months and 4 within 13 to 18 months. Three patients underwent exploratory thoracotomy and 103 patients underwent resection including middle lobectomy in 32 patients, middle-lower lobectomy in 51, middleupper lobectomy in 13, and right pneumonectomy in 7. Altogether 333 N1 and 378 N2 lymph nodes were cleared up. Five patients underwent lateral wall resection of the right lung lower artery and 2 patients underwent artery sleeve resections. One patient died of respiratory failure after the operation. Based on pathologic results, positive lymph nodes of PN1 were identified in 8 cases, PN2 in 6 cases, and both PN1 and PN2 in 21 cases. There were 14 cases in pathological stage I, 34 cases in pathological stage Ⅱ, 51 cases in pathological stage ⅢA, 3 cases in pathological stage ⅢB and 1 case in pathological stage Ⅳ. Followup: The 5year survival rate of the 97 patients was 29.9%. ConclusionsMiddle lobe pulmonary carcinoma sometimes is misdiagnosed as inflammation or tuberculosis, so a reasonable checkup should be performed in time to make a final diagnosis. Because of the anatomic features of middle lobar bronchus, lobectomy in combination with clearance of the mediastinal lymph node should be performed.

Key words: Middle lobe lung cancer, Clinical features, Combine lobectomy, Clearance of mediastinal lymph node