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Vol. 39. Issue 2.
Pages 87-90 (February 2003)
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Vol. 39. Issue 2.
Pages 87-90 (February 2003)
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Lobectomía videoasistida a través del triángulo auscultatorio en el tratamiento quirúrgico del carcinoma broncopulmonar. Experiencia preliminar
Video-assisted lobectomy through the auscultatory triangle for the surgical treatment of bronchopulmonary carcinoma. Preliminary experience
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J.M. Gimferrer
Corresponding author
jgimferr@medicina.ub.es

Correspondencia: Servicio de Cirugía Torácica. Hospital Clínic.Villarroel, 170. 08036 Barcelona. España
, J. Belda, M. Catalán, M. Serra, M. Rubio, M. Iglesias
Institut Clínic de Pneumologia i Cirurgia Toràcica. Hospital Clínic. Universitat de Barcelona. Barcelona. España
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Objetivo

Describir la técnica de la lobectomía videoasis-tida a través del triángulo auscultatorio (LVAA) y valorar los resultados, inmediatos y a medio plazo, obtenidos me-diante este procedimiento quirúrgico en pacientes afectados de carcinoma broncopulmonar no microcítico, estadio I

Pacientes Y Método

Desde abril de 1999 hasta mayo de 2002 hemos realizado 25 LVAA (24 lobectomías y una bilo-bectomía), en 25 pacientes con una edad media de 63,6 años (rango, 39-80)

Resultados

La mortalidad operatoria y postoperatoria fue nula. En dos casos se requirió la conversión a toracotomía convencional. Un paciente fue reintervenido por hemotórax y otro presentó una fístula broncopleural que fue tratado con drenaje pleural. La estancia media hospitalaria fue de 6,3 días. Con un seguimiento medio de 11,5 meses (rango, 1-36), 23 pacientes están libres de enfermedad. La supervivencia ac-tuarial (Kaplan-Meier) a los dos años fue del 93 ± 7%

Conclusiones

La LVAA constituye una intervención se-gura, que requiere sin embargo un aprendizaje específico. En nuestra serie, la morbilidad ha sido escasa y la mortali-dad nula. En los pacientes con carcinoma broncogénico en estadio I, los resultados en los dos primeros años de segui-miento son superponibles a los obtenidos a través de toraco-tomía convencional

Palabras clave:
Lobectomía videoasistida
Videotoracoscopia
Carcinoma broncopulmonar
Objective

To describe a technique for video-assisted lobec-tomy through the auscultatory triangle (VALAT) and to assess early and medium-term outcome of the procedure in patients with non-small cell bronchopulmonary carcinoma in stage I

Patients And Method

Between April 1999 and May 2002 we performed 25 VALAT procedures (24 lobectomies and 1 bilobectomy) in 25 patients with a mean age of 63.6 years (range 39–80)

Results

No deaths occurred during or after surgery. Conversion to conventional thoracotomy was necessary in two cases. One patient was re-operated to resolve hemothorax and one developed a bronchopleural fistula that was treated by pleural drainage. The mean hospital stay was 6.3 days. Twenty-three patients have been disease-free throughout a mean follow-up period of 11.5 months (range 1-36). The two-year actuarial survival rate (Kaplan-Meier) was 93% ± 7%

Conclusions

Valat is a safe procedure that neverthe-less requires specific training. The rate of complications was low in our patient series and mortality was nil. The outcome for patients with stage I bronchogenic carcinoma over a two-year follow-up period has been comparable to results obtained with conventional thoracotomy

Keywords:
Video-assisted lobectomy
Videothoracoscopy
Bronchopulmonary carcinoma
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