Avoidable Vascular Spread in Resection for Bronchial Carcinoma

Abstract

Changes in technique have been a recurring feature in the development of pneumonectomy. Although it is 17 years since the first successful resection, and the operation can now be regarded as safe for the patient, there still remain unsolved problems, particularly those connected with long-term results, and the adaptation of surgical method to specific types of disease. In bronchial carcinoma an impor- tant principle of cancer surgery was applied when radical intrapericardial resection was devised (Allison, 1946), and deriving from this operation special attention was given to the block dissection of cancerous lymphatics; thereafter considerable improvement was promised in the prospects of patients with bronchial carcinoma. At present, however, most series show that five-year survivals occur in little more than one in ten patients after resection, and these results are among the worst of all of cancers treated by surgical removal.