Obiols Carme, Call Sergi, Rami-Porta Ramón, Trujillo-Reyes Juan Carlos
Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain
Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain.
Asian Cardiovasc Thorac Ann. 2015 Oct;23(8):991-4. doi: 10.1177/0218492315579554. Epub 2015 Mar 31.
Bilateral pulmonary nodules represent a challenge in distinguishing between synchronous bronchogenic carcinomas and metastatic disease. In the case of potentially curable synchronous lung cancer, it is recommended to treat each lesion with curative intent if there is no evidence of mediastinal involvement or extrathoracic disease. In this situation, surgical staging of the mediastinum is recommended. This case shows the utility of a transcervical approach to perform precise mediastinal staging and lymphadenectomy, and to access the pleural cavity to resect a pulmonary nodule. Moreover, video-assisted mediastinoscopic lymphadenectomy combined with video-assisted lobectomy could be a good option for a radical lymphadenectomy.
双侧肺结节在鉴别同步性支气管源性癌和转移性疾病方面是一项挑战。对于潜在可治愈的同步性肺癌，如果没有纵隔受累或胸外疾病的证据，建议对每个病灶进行根治性治疗。在这种情况下，推荐进行纵隔的手术分期。本病例展示了经颈入路在进行精确纵隔分期和淋巴结清扫以及进入胸膜腔切除肺结节方面的实用性。此外，电视辅助纵隔镜淋巴结清扫联合电视辅助肺叶切除术可能是根治性淋巴结清扫的一个不错选择。
