Pulmonary Segmentectomy for Tumour

Česká verzia

Authors: T. Horváth ¹; S. Špelda ²; I. Kocáková ²; H. Bartoňková ³; M. Číhalová ⁴; M. Moulis ⁴; B. Garajová ¹; E. Straževská ⁵; J. Vomela ¹
Authors place of work: Chirurgická klinika FN Bohunice, Lékařská fakulta Masarykovy univerzity Brno přednosta: prof. MUDr. Zdeněk Kala, CSc. ¹; Masarykův onkologický ústav, Klinika Komplexní onkologické péče přednosta: prof. MUDr. Rostislav Vyzula, CSc. ²; Masarykův onkologický ústav, Oddělení radiodiagnostiky, přednostka: prim. MUDr. Helena Bartoňková ³; Ústav patologické anatomie FN Bohunice, Lékařská fakulta Masarykovy univerzity Brno přednosta: prof. MUDr. Jirka Mačák, CSc. ⁴; Klinika anesteziologie resuscitace a intenzivní medicíny, LF MU Brno přednosta: prof. MUDr. Pavel Ševčík, CSc. ⁵
Published in the journal: Rozhl. Chir., 2009, roč. 88, č. 5, s. 238-247.
Category: Monothematic special - Original

Summary

Background:
An analysis of outcome data of pulmonary segmentectomy focused on local efficacy in primary non small cell lung cancer and true or seeming lung metastasis.

Patients and methods:
Miscellaneous series of twenty patients treated with classical open procedure involving individuals with primary or metachronous non small cell lung cancer, solitary pulmonary metastasis of extrapulmonary cancer and/or benign pulmonary lesions, lung metastasis mimicing. Thirteen patients after segmentectomy because of malignancy are separated into a group of 7 cases with NSCLC up to 20 mm in diameter, and a group of 6 persons with solitary pulmonary opacity up to 38 mm treated previously surgically for extrapulmonary cancer. Both without enlargement of hilar and/or mediastinal lymphatics proven on preoperative CT imaging. Third part of the group collects benign pulmonary lesions: chondrohamartoma, pneumonitis and pulmonary infarct. Persons involved through a ten years period are followed up at 3(4)-months intervals.

Results:
No perioperative and thirty day mortality was registered. Six cases of distant recurrence were recorded, three in NSCLC and three in extrapulmonary cancer patients. Five patients died within the follow-up period, three of them through the general progression of the oncological disease. Two deaths were non-cancer related. One Rl disease was discovered in a patient with primary lung adenocarcinoma. No local recurrence was recorded in both cancer series with median age of 63 yrs (range 45–79 yrs) and median duration of follow up 35 months.

Conclusion:
Lung segmentectomy seems to accomplish local control of early stage non small cell lung cancer and pulmonary metastasis of extrapulmonary cancer in selected patients.

Key words:
extrapulmonary cancer – lung metastasis – non small cell lung cancer – pulmonary segmentectomy

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