Fuks Leonardo, Fruchter Oren, Amital Anat, Fox Benjamin D, Abdel Rahman Nader, Kramer Mordechai R
The Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 34987, Israel.
Diagn Ther Endosc. 2009;2009:782961. doi: 10.1155/2009/782961. Epub 2010 Feb 7.
Background. Typical pulmonary carcinoids represent less than 5% of primary lung tumors. In patients with typical bronchial carcinoid, formal surgical resection still remains the gold-standard treatment. Data regarding long-term outcome in using flexible bronchoscope-based modalities under conscious sedation is very limited. Objectives. We sought to investigate, over extended follow-up period, the effectiveness of endobronchial resection for carcinoid tumors with curative intent using flexible bronchoscopy. Methods. Nd:YAG laser photoresection using flexible bronchoscope under conscious sedation. Follow-up included repeat bronchoscopy every 6 months and chest CT every year. Results. Ten patients aged 24 to 70 years with endobronchial carcinoid were treated. The tumor location was variable: 2 left Main bronchus, 1 left upper lobe bronchus, 2 right main bronchus, 2 right middle lobe bronchus and 3 right lower lobe bronchus. No major complications were observed. The patients required between 2 and 4 procedures. Patients were followed for a median period of 29 months with no evidence of tumor recurrence. Conclusions. Endobronchial laser photoresection of typical bronchial carcinoids using flexible bronchsocopy under conscious sedation is an effective treatment modality for a subgroup of patients that provides excellent long-term results that are similar to outcome obtained by more invasive procedures.
背景。典型的肺类癌占原发性肺肿瘤的比例不到5%。对于典型支气管类癌患者,正规手术切除仍是金标准治疗方法。关于在清醒镇静下使用基于可弯曲支气管镜的治疗方式的长期疗效的数据非常有限。目的。我们试图在延长的随访期内,研究使用可弯曲支气管镜进行根治性支气管内切除类癌肿瘤的有效性。方法。在清醒镇静下使用可弯曲支气管镜进行钕:钇铝石榴石激光光凝切除术。随访包括每6个月重复进行支气管镜检查和每年进行胸部CT检查。结果。对10例年龄在24至70岁之间的支气管内类癌患者进行了治疗。肿瘤位置各不相同:2例位于左主支气管,1例位于左肺上叶支气管,2例位于右主支气管,2例位于右肺中叶支气管,3例位于右肺下叶支气管。未观察到重大并发症。患者需要进行2至4次手术。患者的中位随访期为29个月,无肿瘤复发迹象。结论。在清醒镇静下使用可弯曲支气管镜对典型支气管类癌进行支气管内激光光凝切除术,对于一部分患者是一种有效的治疗方式,可提供与更具侵入性的手术相似的优异长期疗效。