Chirurgie Des Metastases Pulmonaires Des Cancers Colorectaux

Résumé: The goal of this work is to show the benefit of the surgery in pulmonary metastases of colorectal cancers, as well as the selection criteria of the patients who can benefit from this surgery. Our work is a monocentric exploratory study, going from June 2015 to May 2017 (2 years). 50 pulmonary surgical operations were carried out on 40 patients presenting 58 pulmonary metastases of colorectal cancer, in the Thoracic surgery department Mustapha Pacha hospital Algiers. There were 17 men and 23 women. The median age was 65 years. Pulmonary metastases were bilateral among 7 patients, métachrones in 35 cases. Only 7 metastases were higher than 3 cm. The average of the free disease interval was 23 month. 37 patients did not have a ganglionic invasion. The tumoral markers (ACE) were high among 13 patients. 8 of our patients had hepatic metastases. The mini-invasive surgery (VATS) was carried out among 5 patients. The wedge resection was carried out among 27 our patients, whereas 13 patients underwent an anatomic resection (4 segmentectomies, 7 lobectomies and 2 pneumonectomies). The ganglionic clearing was carried out among 8 patients. Post-operative mortality was worthless; morbidity was of 7.5%. Global survival at one year was of 97% and survival at 3 years was of 88% (CI at 95%: 82.15% --92.59%). Our study confirms that the local control of pulmonary metastases increases the survival of these patients, whose selection criteria must be rigorous so that this surgery is beneficial.

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