Royal Brisbane and Women's Hospital, Department of Vascular Surgery, Butterfield St, Herston, Brisbane, Queensland, Australia.
J Vasc Surg. 2010 Dec;52(6):1518-23. doi: 10.1016/j.jvs.2010.06.153.
Our objective was to assess the short- and long-term outcome for patients after carotid body tumor (CBT) resection and discuss the potential pitfalls of the treatment.
An analysis was undertaken of all patients who underwent CBT resection at Royal Brisbane and Women's Hospital and Greenslopes Private Hospital between 1982 and 2007. Primary tumor characteristics, surgical technique, and outcomes were recorded and analyzed.
A total of 49 consecutive CBT resections (2 recurrent tumors) were carried out in 39 patients (26 women [56%]) who were a mean age of 49 years (range, 17-75 years). A nontender neck mass was the presenting complaint in 85%, followed by screening in familial or contralateral tumors in 26%. Familial cases occurred in 11 patients (28%). There were no operative deaths. Complications occurred in 13 of the 49 operations (27%), predominantly temporary nerve palsies and were more likely to occur in tumors of large volume or in cases of removal of coexisting vagal tumors. Malignant disease was present in seven cases (15%). All patients have been followed-up postoperatively for a mean of 11 years (range, 2-26 years). Metachronous paragangliomas have been discovered in six patients, all with familial disease.
Early resection of carotid body tumors should be undertaken while still small to minimize the risk of neural injury, which increases with tumor size. In cases of bilateral CBT, we recommend that the smaller tumor be resected first, before the staged resection of the larger contralateral tumor. In familial or bilateral tumor cases, other synchronous and metachronous paragangliomas should be excluded. Mandatory lifelong follow-up is essential.
评估颈动脉体瘤（CBT）切除术后患者的短期和长期预后，并讨论治疗的潜在风险。
对 1982 年至 2007 年间在皇家布里斯班妇女医院和格林斯洛普私立医院接受 CBT 切除术的所有患者进行了分析。记录并分析了原发肿瘤特征、手术技术和结果。
39 例患者（26 例女性[56%]）共进行了 49 例连续 CBT 切除术（2 例复发性肿瘤），患者平均年龄为 49 岁（范围 17-75 岁）。85%的患者以无触痛的颈部肿块为首发症状，其次是家族性或对侧肿瘤筛查占 26%。11 例患者（28%）为家族性病例。无手术死亡。49 例手术中有 13 例（27%）发生并发症，主要为暂时性神经麻痹，且体积较大的肿瘤或合并副神经节瘤切除的病例更易发生。7 例（15%）为恶性肿瘤。所有患者术后平均随访 11 年（范围 2-26 年）。6 例患者发现了偶发副神经节瘤，均为家族性疾病。
颈动脉体瘤应在较小的时候进行早期切除，以最大限度地降低神经损伤的风险，随着肿瘤的增大，神经损伤的风险也会增加。对于双侧 CBT，我们建议先切除较小的肿瘤，然后再分期切除对侧较大的肿瘤。在家族性或双侧肿瘤的情况下，应排除其他同步和偶发的副神经节瘤。强制性终身随访是必不可少的。
