Objective To observe the clinical features of primary mid - lobe lung cancer, diagnosis and surgical treatment characteristics. Methods Forty - three cases of primary mid - lobe lung cancer who underwent surgical treatment were retrospectively analyzed from January 1987 to December, 2006. Results The primary mid - lobe lung cancer in this group, 43 cases over the same period accounted for 3.7％ of cases of lung cancer surgery (1 162 cases), age ≥ 50 years of age accounted for 79.1％, males more common. Surgical procedures: simple removal of the mid-lobe of 16 cases, palliative resection in 10 cases, middle and lower lobe lobectomy or middle and upper lobe lobectomy in 6 cases, 4 cases of exploratory thoracotomy, wedge resection in 3 cases, radical surgery in 4 cases. In all patients except one case of postoperative mediastinal emphysema lung sections re- thoracotomy repair leaks, the other had no complications, were cured, 67.44％ survival rate after 1 year, 3 - year survival 25.58％, 5 - year survival 9.3％. Death a year happened to palliative resection and exploratory thoracotomy patients. Conclusion This group of patients is the more advanced, lesions often invaded the pericardium, chest wall and diaphragm, involving the upper lobe or lower lobe, lymph node metastasis of middle lobe bronchial and mediastinal common,surgical results unsatisfactory. Clinicians should enhance the awareness of the mid- lobe lung cancer, to improve early diagnosis rate, and to avoid missing the timing of surgery. It is necessary to have a good knowledge of the patient's lung function and distant metastasis before surgery, to develop an appropriate operation plan as radical resection as possible, simple mid - lobe lobectomy for cancer in limited, non- proliferation or the transfer of cases. If the tumor crosses leaves, viable double lobectomy, sleeve lobectomy or pneumonectomy should be operated. If the tumor has spread or transfer, viable local palliative resection could be operated, but the recurrence rate is high, longterm result is not good.%目的 探讨原发中叶肺癌的临床特点、诊断及外科治疗特点.方法 对1987年1月～2006年12月经外科手术治疗的43例原发中叶肺癌的临床资料进行回顾性分析.结果 本组原发中叶肺癌43例,占同期肺癌手术病例的3.7%,年龄≥50岁的占79.1%,男性多见.手术方式:单纯中叶切除16例,姑息切除10例,中上叶切除或中下叶切除术6例,剖胸探查4例,楔形切除3例,根治术4例.全组病例中除1例术后发生纵隔气肿再次剖胸修补肺断面漏气外,其余均无并发症,均痊愈出院.术后1年生存率67.44%,3年生存率25.58%,5年生存率9.3%.1年内死亡病例均为姑息切除和剖胸探查的患者.结论 本组病例发现时多已是中晚期,病变常侵及心包、胸壁及膈肌,累及上叶或下叶,中叶支气管旁及纵隔淋巴结转移常见,手术效果欠理想.临床医生应提高对中叶肺癌的认识,提高早期确诊率,避免错过手术时机.术前掌握患者的肺功能及远处转移情况,制定合适的手术方案,尽可能行根治性切除,单纯中叶切除适合于肿瘤局限,无扩散或转移的病例.如肿瘤跨叶,可行双肺叶切除、袖式肺叶切除或全肺切除.如肿瘤已扩散或转移,可行局部姑息切除,但复发率高,远期效果差.
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