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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2012, Número 2

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Neumol Cir Torax 2012; 71 (2)


Estadiaje endoscópico en cáncer de pulmón de células no pequeñas

Antillón-Morales S, Herth FJF, Eberhardt R

Idioma: Español
Referencias bibliográficas: 49
Paginas: 158-164
Archivo PDF: 212.23 Kb.


RESUMEN

El estudio histológico de los ganglios mediastinales es con frecuencia necesario para un estadiaje preciso del cáncer de pulmón. Las técnicas por imágenes no invasivas (TC, RMN, PET, PET-TC) ayudan, pero no permiten un diagnóstico histológico. La TBNA es un método seguro, realizable durante una broncoscopía de rutina. Desafortunadamente, éste continúa siendo un método subutilizado en la práctica clínica actual, en gran parte debido a la falta de visualización de la aguja en tiempo real. La introducción de ecoendoscopios ha solucionado este problema. La TBNA guiada por ultrasonido endobronquial (EBUS-TBNA) permite tomar muestras de ganglios paratraqueales, mediastinales e hiliares en tiempo real. Los ganglios mediastinales periesofágicos pueden ser evaluados mediante aspiración por aguja fina guiada por el ultrasonido endoesofágico (EUS-FNA). Estudios recientes, utilizando ambos métodos combinados en la evaluación de las diferentes regiones mediastinales, sugieren que es posible lograr un estadiaje completo y preciso. Se espera que la implementación de métodos endoscópicos mínimamente invasivos como EBUS-TBNA y EUS-FNA permitan reducir significativamente la necesidad del estadiaje quirúrgico del cáncer de pulmón. El objetivo de esta revisión es presentar el tema al cuerpo médico latinoamericano, puesto que estos métodos hoy en día se están implementando en nuestra región.


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