par Bondue, Benjamin 
;Leduc, Dimitri ;Taton, Olivier ;Sokolow, Youri
Référence Revue médicale de Bruxelles, 41, 6, page (416-420)
Publication Publié, 2020-12-01
;Leduc, Dimitri ;Taton, Olivier ;Sokolow, Youri Référence Revue médicale de Bruxelles, 41, 6, page (416-420)
Publication Publié, 2020-12-01
Article révisé par les pairs
| Résumé : | Lung cancer is the world leading cause of cancer related death. Recently two major randomized trials demonstrated the benefit of lung cancer screening strategies by low dose CT (LDCT) scans. Precisely, a 20% and 24% reduction of cancer related mortality was observed in the National Lung Screening trial (NLST) and the NELSON trial, respectively. However, even if the benefit of these trials are equivocal, the initiation of a Belgian lung cancer screening by LDCT should be the subject of discussions and further Belgian's recommendations. With the increasing use of LDCT, numerous pulmonary nodules are detected. As a majority of them is benign, non-invasive diagnostic procedures are mandatory to avoid unnecessary surgical resections. Among these alternative diagnostic procedures, new endoscopic techniques (electromagnetic navigation, cryobiopsy, radial echoendoscopy, CrossCountry, ...) allow to reach the nodule with a high diagnostic yield and with lower risk of complications compared to trans-thoracic approaches. Of course, in patients with a high oncologic risk and without contra-indication, a surgical resection must be performed. However, in order to limit the resection size (segmentectomy instead of lobectomy for example), combined endoscopic and surgical interventions could be performed for hardly palpable lesion. This is especially useful for patients with ground glass opacities. Moreover, this combined approach offer both diagnostic and therapeutic interventions during a single anesthesia. |
