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Vol. 27. Issue 2.
Pages 58-61 (March 1991)
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Vol. 27. Issue 2.
Pages 58-61 (March 1991)
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Resecciones menores en el tratamiento quirúrgico del carcinoma broncogénico en estadio I
Minor resections in the surgical treatment of stage I bronchogenic carcinoma
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R. Peñalver Pascual, J. Zapatero Gaviria, J. Lago Viguera, L. Madrigal Royo, B. Baschwitz Gómez, M. Córdoba Peláez, J. Candelas Barrios
Servicios de Cirugía Torácica. Hospital Ramón y Cajal. Madrid
A. Golpe Gómez*
* Neumología. Hospital Ramón y Cajal. Madrid
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De un total de 403 enfermos intervenidos quirúrgicamente por carcinoma broncogénico en nuestro servicio entre 1977 y 1987, en 40 casos efectuamos una resección menor, segmen-tectomía atípica o resección en cufia, con intención curativa.

Todos los enfermos se encontraban en estadio I, habiendo sido estudiados preoperatoriamente mediante radiografía de tórax y TAC torácica o gammagrafía con galio para evaluar la extensión intratorácica de su enfermedad; y postoperatoriamente después de revisar histológicamente el espécimen resecado y todos los ganglios biliares y mediastínicos sospechosos extirpados.

La mortalidad postoperatoria fue nula y la morbilidad muy baja (2,5%). La supervivencia acumulativa fue del 55% al tercer ano y 46% al quinto ano. El índice de recidivas locales ha sido del 5%.

El análisis estadístico comparativo realizado entre estos datos y los recogidos de los 77 enfermos, que en el mismo período de tiempo y en el mismo estadio I fueron sometidos a lobectomía, no mostró diferencias de significación estadística.

La resección menor podría ser considerada como el tratamiento quirúrgico idóneo del carcinoma broncogénico en estadio I, cuando la situación anatómica en la periferia haga posible su extirpación completa mediante esta técnica.

From a total series of 403 patients with bronchogenic carcinoma who underwent surgical treatment between 1977 and 1987, 40 patients were selectively treated with a minor resection, atypical segmentectomy or wedge resection with a curative intention. All patients were in stage I. Preoperative stu-dies included thoracic radiography and computerized tomography of the thorax or gallium radionuclide gammagraphy to evaluate the extent of the intrathoracic lesion. Postoperative histologic examination was performed in all resected specimens (lung and hiliary and mediastinal ganglia). There was no postoperative mortality. Postoperative morbility was very low (2,5%). Cumulated survival at 3 years was 55% and at five years 46%. Local relapsing rate was about 5%.

Comparison of these patients with another group of 77 patients in stage I who during the same period of time were subjected to lobectomy, failed to show statistically significant differences between the two groups of treatment. Therefore, minor pulmonary resection might be considered as an appropiate surgical treatment of stage I bronchogenic carcinoma whenever the peripheral anatomic field allows complete resection with this techinique.

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Copyright © 1991. Sociedad Española de Neumología y Cirugía Torácica
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