Selection Criteria in C.B.P.

Criterios de Selección en la cirugía del C.B.P.

Chifflet, Juan - Bogliaccini, Gustavo - Bertullo, Hugo - Domínguez, Carlos

Resumen:

Extension, histological type and host condition are the most important factors influencing prognosis in lung cancer. The best results are given by surgery which must be selective, otherwise it may become harmful. The most important repercussions of resective approach are in the respiratory and cardiovascular system. According to lung and cardiovascular function, patients are divided in 3 groups: poor and high risk patients and the inoperable ones. TNM classification approved in 1978 in Argentina is used when evaluating lung cancer spread. The histotogical classification chosen is that one whichdivides tumors in oat-cell and not oat-cell. The oat-cel carcinoma, those in stage IV are inoperable. Patients in stage I and II are surgical candidates. Those in stage III are difficult to manage. Surgery in this stage must be performed when there are maximum possibilities of complete resection. Node involvement leads us to a worse prognosis mainly if it is a mediastinal involvement.


En el C.B.P., el pronóstico depende de su extensión y el terreno.La cirugía obtiene los mejores resultados terapéuticos, pero realizada sin criterio selectivo puede ser perjudicial.En terreno se valma el riesgo quinírgico y la funcionalidad post-operatoria alejada. La repercusión más importante se produce en los sistemas respiratorios y cardiovascular, influyendoserecíprocamente.Se analizan los elementos clínicos y paraclínicos para una evaluación pulmonar y cardiovascular del paciente, dividiéndolos en: operables con bajo riesgo, los de alto riesgo y los inoperables, resaltando los de alto riesgo.En la extensión nos guiamos por la clasificación TNM Histológicamente: el oat-cell no es quirurgico. Los estadios IV no son quinírgicos con pretensiones curativas. Son quinírgicos los estadios I y II. El estadio III es el discutido; en éste se analizan las posibles extensiones del tumor y su resecabilidad.Está indicada la cirugía cuando existen las máximas posibilidades de resección completa. La invasión linfatica ensombrece el pronostico, sobretodo las mediastinales.Los pacientes inmunodeficitarios tienen peor pronóstico que los de buen nivel inmunitario. La cirugía es un factor inmunodepresor.


Detalles Bibliográficos
1982
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Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/3323
Acceso abierto
Resumen:
Sumario:Extension, histological type and host condition are the most important factors influencing prognosis in lung cancer. The best results are given by surgery which must be selective, otherwise it may become harmful. The most important repercussions of resective approach are in the respiratory and cardiovascular system. According to lung and cardiovascular function, patients are divided in 3 groups: poor and high risk patients and the inoperable ones. TNM classification approved in 1978 in Argentina is used when evaluating lung cancer spread. The histotogical classification chosen is that one whichdivides tumors in oat-cell and not oat-cell. The oat-cel carcinoma, those in stage IV are inoperable. Patients in stage I and II are surgical candidates. Those in stage III are difficult to manage. Surgery in this stage must be performed when there are maximum possibilities of complete resection. Node involvement leads us to a worse prognosis mainly if it is a mediastinal involvement.