Tuberc Respir Dis.  1990 Sep;37(3):258-267. 10.4046/trd.1990.37.3.258.

Operative Method for the Treatment of Lung Carcinoma

• KMID: 2528481
• DOI: http://doi.org/10.4046/trd.1990.37.3.258

Abstract

We have reviewed 200 cases of primary carcinoma of the lung for 14 years from March, 1976 to February 1990 at the Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea. There were 60 males & 40 females with 77% ranging above 50 years old. There were 133 (26.6%) cases of squamous cell carcinoma, 37 (7.4%) cases of adenocarcinoma, 9 (1.8%) cases of bronchoalveolar cell carcinoma, 8 cases of large cell carcinoma and 4 cases of adenosquamous cell carcinoma. There were one carcinoma in situ, 80 cases in stage 1, 35 cases in stage II, 73 cases in stage IIIa, 10 cases in stage IIIb, one cases in unclassified with new international staging for lung cancer. Preoperative mediastinoscopy and or mediastinotomy were performed in 45 cases in recent. There were 3 partial rib resection and one wedge resection of right middle lobe (RML) in 16 cases of right upper lobe (RUL) lobectomy & one wedge resection of right lower lobe (RLL) in 3 cases of right middle lobe (RML) & one wedge resection of RUL in 12 cases of right lower lobe (RLL) lobectomy. One sleeve lobectomy in 6 cases of right upper lobe (RUL) & right middle lobe (RML) bilobectomy, & one sleeve pneumonectomy and one partial rib resection in 39 cases of right pneumonectomy were performed. One sleeve lobectomy & wedge resection of RML in 14 cases of RUL lobectomy. Sixty cases of left pneumonectomy were performed. There were 26 cases of post-operative complications; 6 cases of empyema thoracis, 7 cases of carcinoma invasion to bronchial stump, 3 cases of hemothorax, one case of cylothorax, 3 cases of vocal cord paralysis, one phrenic N . palsy, one upper gastrointestinal bleeding (UGI bleeding), wound infection in one, renal failure in one, myasthenic syndrome in one, carina stenosis in one. There were 5 operative mortalities; 4 cases of respiratory; failure due to myasthenic syndrome in 0ne, empyema thoracis in one, explo-laparotomy due to UGI bleeding in one and carinal repair for carinal stenosis after left pneumonectomy in one, one case of brain metastases There were 28 cases of N₂ metastases without N₁ metastases in 47 medinastinal sites. The 3-year survival rate were 70% in stage 1 and 39% in stage 11, and the 2-year survival rate were 43% in stage IIIa. We have concluded that we have to perform complete resection with radical mediastinal lymphnode dissection in the surgical treatment of bronchogenic carcinoma even though no N₁ metastases.