胸部外科手術後の難治性感染症に対する有茎性大網充填術の有用性

金沢大学医薬保健研究域医学系We present a series of 8 consecutive patients who underwent the omental pedicle flap method in the field of thoracic surgery. Four of them had empyema with bronchopleural fistula and four had mediastinal infection. A pedicle of omentum containing the right gastroepiploic artery was passed through a tunnel in the diaphragm into the empyema cavity or the mediastinal abscess cavity. All eight patients were cured successfully by single-stage procedures. We think this series demonstrates the value of omental pedicle flap method which lacks in symptoms due to defected organ and offers an excellent therapeutic effect with easy operative procedure. And, this method produce a quality of life. Further active application of this method can be expected in the management of chest problems.

80歳以上の高齢者肺癌に対する肺癌切除症例の検討

金沢大学医薬保健研究域医学系Seventeen lung cancer patients over 80 years of age were treated surgically at Kanazawa University Hospital from 1973 to 1991. The operative procedures were lobectomy (six patients), segmentectomy (seven patients), partial resection (three patients) and exploratory thoracotomy (one patient). Absolutely curative resection was done in two patients, relatively curative resection in two, relatively non-curative resection in ten, absolutely non-curative resection in two. The three-year survival rate after operation for all seventeen patients was 60.2%. Postoperative complication developed in eleven patients (64.7%). Patients who had lobectomy with mediastinal lymph node dissection had a high incidence of postoperative complications. In recent years, pulmonary resections have been performed in patients over 80 years of age who have been managed with pulmonary rehabilitation, resulting in better course. It is concluded that the limited resections produce good prognosis in patients over 80 years of age with lung cancer.

T4肺癌に対する一時バイパス法による大動脈合併切除術

金沢大学医薬保健研究域医学系Radical operation for T4 lung cancer is technically difficult. We report here 3 cases of T4N0M0 lung cancer involving aorta or left subclavian artery which was successfully operated on. We could carry out combined aortic resection more safely and speedy under the assistant devices, such as Anthrontube and Biomedicus Centrifugal Pump. Even T4 lung cancer having aortic invasion with N0 disease can be operated on and be expected long-term survival using these assistant devices.1

胸腺腫の外科治療

金沢大学医薬保健研究域医学系Sixty-seven patients with thymoma were surgically treated during the past 19 years in our department. The 5-year, 10-year and 15-year survival rates of total cases with thymomas were 69.2%, 59.6% and 59.6%, respectively. Survival rates of thymoma with MG and without MG were not significantly different. According to clinical stages in Masaoka\u27s classification, there were significant difference between Stage I and Stag III (p < 0.05), Stage I and Stage IV a (p < 0.01), and Stage I and Stage IV b (p < 0.01). We can conclude that complete resection of thymomas lead to better prognosis, and immunochemotherapy using cyclophosphamide, vincristine and OK-432 are effective.