grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2018-177-3-19-24grekov-909Research ArticleВОПРОСЫ ОБЩЕЙ И ЧАСТНОЙ ХИРУРГИИPROBLEMS OF GENERAL AND SPECIAL SURGERYБРОНХО- И АНГИОПЛАСТИЧЕСКАЯ ЛОБЭКТОМИЯ КАК АЛЬТЕРНАТИВА ПНЕВМОНЭКТОМИИ В ЛЕЧЕНИИ НЕМЕЛКОКЛЕТОЧНОГО РАКА ЛЕГКОГОBRONCHO- AND ANGIOPLASTY LOBECTOMY AS AN ALTERNATIVE TO PNEUMONECTOMY IN TREATMENT OF NON-SMALL-CELL LUNG CANCERРешетовА. В.ReshetovA. V.

Решетов Алексей Викторович - кандидат медицинских наук, доцент.

191015,Санкт-Петербург, ул. Кирочная д. 41

St. Petersburg

reshetal@mail.ruЕлькинА. В.ElkinA. V.

Елькин Алексей Владимирович - доктор медицинских наук, профессор, зав. кафедрой фтизиопульмонологии и торакальной хирургии.

191015,Санкт-Петербург, ул. Кирочная д. 41

St. Petersburg

Aleksei.Elkin@szgmu.ruНиколаевГ. В.NikolaevG. V.

Николаев Герман Викторович - кандидат медицинских наук.

197341, Санкт-Петербург, ул. Аккуратова, д. 2

St. Petersburg

Nikolaevg@mail.ruСтепановС. С.StepanovS. S.

Степанов Сергей Сергеевич.

197341, Санкт-Петербург, ул. Аккуратова, д. 2

St. Petersburg

Sergstep@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет имени И. И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education North-Western State Medical University named after I. I. MechnikovRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution «Almazov National Medical Research Centre» of the Ministry of Health of the Russian FederationRussian Federation20182806201817731924Copyright © Решетов А.В., Елькин А.В., Николаев Г.В., Степанов С.С., 20182018Решетов А.В., Елькин А.В., Николаев Г.В., Степанов С.С.Reshetov A.V., Elkin A.V., Nikolaev G.V., Stepanov S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/909Цель исследования

Цель исследования. Обосновать применение бронхо- и ангиопластических лобэктомий как альтернативу пневмонэктомии при немелкоклеточном раке легкого (НМРЛ).

Материал и методы

Материал и методы. Представлены результаты лечения двух сопоставимых групп пациентов с НМРЛ. В одной группе пациентам выполняли бронхо- или ангиопластическую лобэктомию (группа А), в другой – пневмонэктомию (группа Б). Проанализировано количество осложнений, общая и безрецидивная выживаемость в обеих группах, а также факторы, влияющие на результаты.

Результаты

Результаты. Число послеоперационных осложнений в группе А и группе Б составило 12,5 и 15,6 % соответственно. Медиана безрецидивной выживаемости и общей выживаемости в группах достоверно не отличалась, составляя в группе А 20 и 48 месяцев, а в группе Б – 19 и 25 месяцев (р=0,91 и р=0,97). На результаты лечения достоверно влияли лишь стадия заболевания (р=0,017) и проведение мультидисциплинарного лечения (р=0,007), включающего химио- и лучевую терапию.

Заключение

Заключение. Выполнение бронхо- и ангиопластических лобэктомий может быть оправдано как альтернатива удалению легкого при НМРЛ в рамках мультидисциплинарного лечения.

The objective of the study is to substantiate the applying of broncho- and angioplasty lobectomy as an alternative to pneumonectomy in NSCLC.

Material and methods

Material and methods. The results of treatment of two comparable groups of patients with NSCLC were presented. In one group, patients underwent broncho- or angioplasty lobectomies (group A), in another – pneumonectomy (group B). The number of complications, overall and disease-free survival in both groups, as well as the factors affected the results were analyzed.

Results

Results. The number of postoperative complications in group A and group B was 12.5 % and 15.6 %, respectively. The median of disease-free survival and overall survival in both groups did not differ meaningfully, consisting of 20 months and 48 months in group A, and 19 months and 25 months in group B (p=0.91) and (p=0.97). The results of treatment were meaningfully affected only by the stage of the disease (p=0.017) and multidisciplinary treatment (p=0.007), including chemotherapy and radiation therapy.

Conclusions

Conclusions. Performing of broncho- and angioplasty lobectomies can be justified as an alternative to lung removal in NSCLC within the multidisciplinary treatment.

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The authors declare that there are no conflicts of interest present.