Surgical treatment of bronchial carcinoma

The surgical treatment of 2430 patients suffering from bronchial carcinoma between 1950 and 1978 is analysed and emphasis placed on conservative surgery. The histological pattern is described, with marked prevalence of the squamous-cell carcinomas. The increased age in the general population means that many patients aged 70 years or over present for surgical treatment and respond well to lobectomy or segmental resection. The place of preoperative radiotherapy in the treatment of oat-cell carcinoma is considered and it is concluded that improved results are obtained by this combined treatment. The serious consequences of a postoperative bronchial fistula are noted and the lower incidence that may be obtained by bronchial stapling is mentioned. The significance of a positive mediastinal node is stressed in relation to a long-term result from surgery, and methods whereby these results could be improved in the future are discussed.