RESUMO
Patients with resectable non-small cell lung cancer have a chance to reach a 5-year survival rates ranging from 70% or more for stage IA and 20% for stage IIIA. These figures have remained stable for the past 20 years. Moreover, the inability to improve long-term outcomes is generally determined by a fatal disease progression due to the emergence of distant metastases or local recurrence often in combination with systemic progression process. Thus the use of chemotherapy both in neoadjuvant and adjuvant regimens has stimulated for a long time the search for the optimal scheme and treatment options. This article presents a critical analysis of the current state of the problem of neoadjuvant and adjuvant chemotherapy as well as chemoradiotherapy in order to optimize the tactics of combined treatment of these groups of patients.
Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/terapia , Terapia Neoadjuvante/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Quimiorradioterapia Adjuvante , Quimioterapia Adjuvante , Progressão da Doença , Medicina Baseada em Evidências , Humanos , Neoplasias Pulmonares/mortalidade , Recidiva Local de Neoplasia/prevenção & controleRESUMO
Main methods of bronchus suturing after lung resection are presented in the article. The safest methods of bronchus closure are manual and mechanical suturing with use of UB apparatus. Use of UO or TL-TLH apparatus with longitudinal orientation of tantalic brackets significantly increases the frequent of bronchus suture failure. It is determined by deterioration of bronchus blood supply and poor trophic healing of bronchus wound.
