Stamatis G, Freitag L, Greschuchna D
Department of Thoracic Surgery and Endoscopy, Ruhrlandklinik, Essen-Heidhausen, FRG.
Eur J Cardiothorac Surg. 1990;4(10):527-32; discussion 533. doi: 10.1016/1010-7940(90)90140-u.
Bronchopulmonary carcinoid tumours occur at all levels from the trachea to the lung periphery. Over a 20-year period. 227 patients with carcinoid tumour underwent thoracotomy. The age at operation ranged from 14 to 79 years. Haemoptysis, chronic cough, recurrent infection and wheeze were the most common symptoms; 24% of patients were asymptomatic. The primary tumour was within the trachea or the main, lobar or segmental bronchi in 190 patients (83.7%). A variety of surgical procedures were employed: pneumonectomy in 32 patients; lobectomy and bilobectomy including bronchial sleeve resection in 144; segmentectomy in 18; wedge excision in 19; bronchial sleeve only in 5; carinal resection in 2; tracheal resection in 4 and bronchotomy in 3 cases. There was only 1 hospital death in the 227 patients (mortality: 0.44%). Survival at 5 and 10 years in patients with benign carcinoid was 97.5% and 95%, respectively. In patients with the atypical form it was 41.2%. The peripheral carcinoid was usually totally removed by an ample wedge excision or segmental resection and the central bronchial carcinoid by sleeve resection with lobectomy rather than pneumonectomy. The atypical variant, because of the frequency of lymphatic involvement, should be treated as a bronchial carcinoma by radical resection.
支气管肺类癌肿瘤可发生于从气管到肺周边的各个层面。在20年期间，227例类癌肿瘤患者接受了开胸手术。手术年龄范围为14至79岁。咯血、慢性咳嗽、反复感染和喘息是最常见的症状；24%的患者无症状。190例患者（83.7%）的原发肿瘤位于气管、主支气管、叶支气管或段支气管内。采用了多种手术方法：32例行肺切除术；144例行肺叶切除术和双肺叶切除术，包括支气管袖状切除术；18例行段切除术；19例行楔形切除术；5例仅行支气管袖状切除术；2例行隆突切除术；4例行气管切除术；3例行支气管切开术。227例患者中仅有1例医院死亡（死亡率：0.44%）。良性类癌患者5年和10年生存率分别为97.5%和95%。非典型类癌患者的生存率为41.2%。周围型类癌通常通过充分的楔形切除术或段切除术完全切除，中央型支气管类癌通过肺叶切除加袖状切除术而非肺切除术切除。由于非典型类癌常有淋巴结受累，应按支气管癌行根治性切除治疗。
