Lung cancer causes the highest number of cancer-related death in China. Complete surgical resection is currently the best treatment modality for lung cancer. However, only one third of patients with lung cancer can be identified as candidates for operation. The other two thirds are inoperable, because they have late disease with distant metastasis or locally advanced lung cancer involving neighboring organs. Recently introduction of the theory and technique of cardiovascular surgery into lung cancer surgery has made possible en bloc resection of the lung combined with part of the involved left atrium, aorta, superior vena cava, and pulmonary artery. It has made possible for the patients with locally advanced lung cancer, who were thought as surgical contraindication or incurable cases, to not only have complete resection of the tumor, but also achieved long term survival and good life quality without evidence of recurrence and distant metastasis of the cancer.This paper will provide a brief background at the progression of surgical theory and technology of locally advanced lung cancer in China. Besides, the indication, present methods, results of surgical management and multimodality treatment for locally advanced lung cancer, including extended resection and reconstruction of superior vena cava, left atrium, aorta and pulmonary artery will be presented. Finally, the perioperative management for the extended resection of locally advanced lung cancer will also be discussed.

Biopsy, Fine-Needle ; methods ; Bronchi ; diagnostic imaging ; pathology ; China ; Endosonography ; methods ; Humans ; Lung Neoplasms ; diagnosis

Objective To explore the cause,classification,incidence rate,diagnosis and treatment of pulmonary sequestration.MethodsThe data of 22 cases was analysed and the literatures were reviewed.ResultsThere were 22 cases of sequestration that confirmed by pathology after resected in our department from 1997 to 2007,of which 16 cases(72.7%)were confirmed before operation.The incidence rate was 5.7% comparing with the same time lobectomy.There were 20 cases(91%) of intralobar type and 2 cases(9%) of extralobar type.In intralobar type,18 cases were accompanied with infection and 2 cases with hemoptysis.2 cases had no symptom in extralobartype.ConclusionPulmonary sequestration is not an rare disease.The diagnosis mainly depends on X-ray.Sometimes,bronchography,retrograde arteriography or CT can also help making the diagnosis correctly.Operation is the main treatment method.Special attention should be paid to avoiding injure to the vessels during operation.