Nowadays, the popularization of endoscopic technology makes a substantial increase in the diagnosis rate of esophageal multiple primary carcinoma. However, the multiple primary carcinoma combined with esophageal cancer, lung cancer and cardiac cancer is relatively rare. This paper reported a 64-year-old male with multiple primary cancer who received one-stage complex radical surgery, including radical resection of esophageal cancer, lung cancer and cardiac cancer. After the operation, the patient presented chylothorax and conservative treatment was ineffective. Then we preformed ligation of thoracic duct through single-portal thoracoscope. The patient recovered successfully after surgery and the follow-up results showed well.
目的總結針對局部進展期非小細胞肺癌（LA-NSCLC）施行肺癌擴大指征手術的臨床經驗。 方法回顧性分析2008年1月至2012年12月同濟大學附屬東方醫院胸心外科非計劃性實施肺癌擴大指征手術治療的14例LA-NSCLC患者的臨床資料，其中男9例、女5例，年齡30～67（59.5±6.1）歲。行胸壁切除與重建術2例，主動脈切除及重建術1例，肺癌上腔靜脈切除重建術3例，椎體部分切除術1例，左心房部分切除術1例，肺上溝瘤外科治療2例，袖形全肺切除或肺葉切除隆突成形術3例，支氣管肺動脈成形術1例。 結果本組患者無圍手術期死亡病例。術后病理診斷鱗癌7例，腺癌4例，鱗腺癌1例，腺樣囊性癌2例。隨訪18.5（7～48）個月。全組患者中術后生存時間最長者超過4年；3例分別于術后7個月、11個月和17個月死于腫瘤遠處轉移；1例存活26個月，1例存活20個月，另1例術后3個月并發肺部感染死亡；4例已存活3年以上；另有3例術后隨訪至2013年9月，隨訪時間未滿1年仍存活。 結論肺癌擴大指征手術能使LA-NSCLC患者獲得肺癌的完全性切除，其中相當部分患者術后可獲良好的近遠期效果，因此外科治療依舊是肺癌治療的基石，對有條件手術者應力爭手術治療。