Saad Júnior R, Ethel Filho J, D'Andretta Neto C, Lee A D, Tseng T C, Barros S M
AMB Rev Assoc Med Bras. 1989 Jan-Feb;35(1):23-8.
We reviewed 19 patients who had undergone thoracotomy and resection of a noncalcified solitary pulmonary nodule over the past 7 years, to see if a policy of early thoracotomy was therapeutically valid. The average age of patients was 50 (range 10 to 73 years), 6 females and 13 males. All of them asymptomatic. In this study, there were 9 (47.3%) of primary bronchogenic carcinoma, the incidence was 54.5% in patients above 50 years. There were no postoperative deaths and 3 serious postoperative complications (15.7%). Post operatory followed up by all patients ranged from one to seven years. The patients with benign lesions are all well. 9 of the cases had primary lung cancer, 2 died, 3 1/2 years and 5 years after surgery. We conclude that pre-operative differential diagnostic procedure between benign and malign nodules may not always be decisive, and that an early thoracotomy in indicated every case, since the incidence of malign tumors is frequent. Very small primary lung cancers detected and treated early do not have the same poor prognosis as larger primary cancers.
我们回顾了过去7年中19例接受开胸手术并切除非钙化孤立性肺结节的患者,以探讨早期开胸手术策略在治疗上是否有效。患者的平均年龄为50岁(范围为10至73岁),其中女性6例,男性13例。他们均无症状。本研究中,原发性支气管肺癌患者有9例(47.3%),50岁以上患者的发病率为54.5%。无术后死亡病例,有3例严重术后并发症(15.7%)。所有患者术后随访时间为1至7年。良性病变患者情况均良好。9例为原发性肺癌,2例分别在术后3年半和5年死亡。我们得出结论,术前对良性和恶性结节进行鉴别诊断的程序可能并不总是具有决定性,鉴于恶性肿瘤的发病率较高,因此在每种情况下都应尽早进行开胸手术。早期发现并治疗的非常小的原发性肺癌,其预后与较大的原发性肺癌不同,不会那么差。