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Vol. 47. Issue S3.
I Foro Nacional de Cirujanos Torácicos en Formación
Pages 15-24 (May 2011)
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Vol. 47. Issue S3.
I Foro Nacional de Cirujanos Torácicos en Formación
Pages 15-24 (May 2011)
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Cirugía de la pared torácica
Chest wall surgery
Visits
...
Jose Luis Campo-Cañaveral De La Cruza, Jorge Herrero Collantesb, David Sánchez Lorentec, Juan Torres Lanzasd,
Corresponding author
jtljimena@hotmail.com

Autor para correspondencia.
a Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
b Servicio de Cirugía Torácica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
c Servicio de Cirugía Torácica-Institut del Tórax, Hospital Clínic, Barcelona, España
d Servicio de Cirugía Torácica, Hospital Universitario Virgen de la Arrixaca, Murcia, España
Article information
Resumen

La cirugía de la pared torácica, a pesar de las múltiples diferencias de las diferentes patologías que presenta, comparte aspectos comunes en su tratamiento quirúrgico. El tratamiento ha ido cambiando en el curso de los últimos años gracias a los avances producidos en las técnicas diagnósticas, los procedimientos mínimamente invasivos y en los materiales de reconstrucción, pero sobre todo en el manejo interdisciplinario de muchas de las patologías.

La corrección mínimamente invasiva de Nuss ha ido ganando adeptos en el tratamiento del pectus, aunque los abordajes abiertos cada vez se realizan a través de incisiones más pequeñas, casi comparables a las incisiones laterales en la técnica de Nuss. Los partidarios del abordaje abierto hacen referencia también a las desventajas evidentes de la necesidad de portar un implante de acero durante 2 o 3 años y de una segunda intervención para retirar dicho implante.

Las técnicas de resección en bloque con reconstrucción mediante materiales, cada vez mejores y cubiertos por injertos miocutáneos en colaboración con los servicios de cirugía plástica, han supuesto un notable avance en el tratamiento de los tumores de pared.

El tratamiento trimodal del tumor de Pancoast, consistente en una inducción con quimioterapia y radioterapia y posteriormente tratamiento quirúrgico del tumor, es en la actualidad el que mejores resultados ofrece en términos de resecabilidad y supervivencia.

Palabras clave:
Pared torácica
Pectus excavatum
Tumores de pared torácica
Pancoast
Abstract

Despite the numerous differences among the distinct diseases of the chest wall, the surgery of this area shows certain common features. Treatment has progressively changed in the last few years due to advances in diagnostic techniques, minimally invasive procedures and reconstruction materials, and especially due to the multidisciplinary management of many diseases.

Nuss’ minimally invasive correction of pectus excavatum has gained devotees, although open approaches are performed with increasingly small incisions, almost comparable to the lateral incisions in Nuss’ technique. Surgeons supporting the open approach also cite the evident disadvantages of the need for a steel implant for 2 or 3 years and for a second intervention to remove this implant.

En-bloc resections with reconstruction using materials, which are increasingly better and covered by myocutaneous grafts in collaboration with plastic surgery departments, constitute a major advance in the treatment of chest wall tumors.

Trimodal therapy for Pancoast tumors, consisting of induction chemotherapy and radiotherapy and subsequent surgical treatment of the tumor, currently provides the best results in terms of resectability and survival.

Keywords:
Chest wall
Pectus excavatum
Chest wall tumors
Pancoast
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Copyright © 2011. Sociedad Española de Neumología y Cirugía Torácica
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