目的总结针对局部进展期非小细胞肺癌（LA-NSCLC）施行肺癌扩大指征手术的临床经验。 方法回顾性分析2008年1月至2012年12月同济大学附属东方医院胸心外科非计划性实施肺癌扩大指征手术治疗的14例LA-NSCLC患者的临床资料，其中男9例、女5例，年龄30～67（59.5±6.1）岁。行胸壁切除与重建术2例，主动脉切除及重建术1例，肺癌上腔静脉切除重建术3例，椎体部分切除术1例，左心房部分切除术1例，肺上沟瘤外科治疗2例，袖形全肺切除或肺叶切除隆突成形术3例，支气管肺动脉成形术1例。 结果本组患者无围手术期死亡病例。术后病理诊断鳞癌7例，腺癌4例，鳞腺癌1例，腺样囊性癌2例。随访18.5（7～48）个月。全组患者中术后生存时间最长者超过4年；3例分别于术后7个月、11个月和17个月死于肿瘤远处转移；1例存活26个月，1例存活20个月，另1例术后3个月并发肺部感染死亡；4例已存活3年以上；另有3例术后随访至2013年9月，随访时间未满1年仍存活。 结论肺癌扩大指征手术能使LA-NSCLC患者获得肺癌的完全性切除，其中相当部分患者术后可获良好的近远期效果，因此外科治疗依旧是肺癌治疗的基石，对有条件手术者应力争手术治疗。
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.