Résections pulmonaires majeures endoscopiques pour carcinome bronchique de stade I

Twenty-five to 30% of the lobectomies for stage I- non small cell bronchial carcinomas (NSCBC) are done using a video-assisted technique or a thoracoscopic approach in the United States and in Japan. In France, these techniques remain at a limited level and are often criticized. No prospective randomized trial comparing open and thoracoscopic lobectomies has been conducted. The more the experience is growing, the less chance there is for a trial. However, many large series have recently been published as well as a recent meta-analysis of 21 studies, demonstrating that the morbidity of these techniques is lower than the morbidity of thoracotomy and that the survival is equivalent if not superior. Basing on our series of 114 major pulmonary resections for stage I- NSCBC performed under a totally endoscopic approach, the benefits and the limitations of these techniques are discussed.