常用的外科手术方式有几种？

随着医学科学、近代麻醉学、手术器械和微创胸外科技术的发展，肺外科手术在肺癌综合治疗的地位与价值愈来愈受到重视。肺癌外科手术随着电视胸腔镜和微创胸外科技术的开展而有所发展，电视胸腔镜微创手术的肺楔形切除、肺叶切除、不明原因胸腔积液的胸膜活检已在全国普遍开展。

可以肯定地讲：I 期、Ⅱ期和部分高度选择的ⅢA非小细胞肺癌病人可以从外科手术中获益。

肺癌常用的手术方式：肺叶切除+纵隔淋巴结清除术是目前肺癌切除最常用的术式。约占肺癌肺切除手术的70%。支气管袖式成型肺叶切除主要是针对一组特殊的中心型肺癌患者，支气管镜提示肿瘤位于或侵犯叶支气管开口处。术中支气管残端送冰冻病理检查已经成为常规。全肺切除术，近年来逐渐减少，特别是对于高龄肺癌患者更要慎重。局部切除术：包括肺段切除和楔形切除。近年来电视胸腔镜肺局部切除给高龄早期肺癌患者带来生存益处。　　

肺切除加系统性胸内淋巴结清扫术是非小细胞肺癌的规范性术式。新近几年开展的电视胸腔镜肺叶切除+系统性胸内淋巴结清扫术在各大城市进步很快，其不断增长的医疗费用所导致卫生经济学的争论也在继续。希望医保部门重视并给于政策上的倾斜和支持！

此外，不损伤胸壁肌肉的小切口开胸肺癌根治术给更多中小城市的肺癌患者带来高质量的生活和低廉的医疗费用。值得推广。

 【英语园地】 Surgery

A thoracic surgeon is specially trained to perform lung cancer surgery. The goal of surgery is complete removal of the lung tumor and the nearby lymph nodes in the chest. The tumor must be removed with a surrounding border of normal lung tissue (called the margin). A "negative margin" means that when the pathologist examines the lung, or piece of lung that has been removed by the surgeon, no traces of cancer were found in the healthy tissue surrounding the tumor.

The lungs have five lobes, three in the right lung and two in the left lung. For NSCLC, a lobectomy (removing of an entire lobe of the lung) has been shown to be the most effective type of surgery, even when the lung tumor is very small. If, for whatever reason, the surgeon cannot remove an entire lobe of the lung, the surgeon can remove the tumor in a procedure called a wedge, surrounded by a margin of normal lung. If the tumor is close to the center of the chest, the surgeon may have to perform a pneumonectomy (surgery to remove the entire lung). The time it takes to recover from lung surgery depends on how much of the lung is removed and the health of the patient before surgery.