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针对支气管内类癌肿瘤,不进行肺切除的单纯支气管支气管成形切除术。

Pure bronchoplastic resections of the bronchus without pulmonary resection for endobronchial carcinoid tumours.

作者信息

Nowak Kai, Karenovics Wolfram, Nicholson Andrew G, Jordan Simon, Dusmet Michael

机构信息

Department of Thoracic Surgery, Royal Brompton Hospital, London, UK.

出版信息

Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):291-4; discussion 294-5. doi: 10.1093/icvts/ivt154. Epub 2013 Apr 28.

Abstract

OBJECTIVES

Bronchopulmonary carcinoid tumours are relatively uncommon primary lung neoplasms. A small proportion of these lesions are predominantly endobronchial and do not extend beyond the bronchial wall. Endoscopic resection can be performed, but carries around a one in three risk of local recurrence and, therefore, mandates long-term surveillance. An alternative is complete surgical resection via bronchoplastic resection. We present our experience of surgical resection in patients with endobronchial carcinoids.

METHODS

From 2000 to 2010, 13 patients (age 45±16 years, 10 males) underwent pure bronchoplastic resection, including systematic nodal dissection, for endobronchial carcinoid tumours, without the resection of lung parenchyma.

RESULTS

There was no significant operative morbidity or mortality. This is a retrospective review of a consecutive case series. The last follow-up for all patients was obtained in 2011. The mean maximum tumour size was 18±8 mm. No lymph node invasion was observed. The median follow-up was 6.3±3.3 years, with no regional recurrence. In 1 case, a tumourlet was identified at 5 years in the contralateral airway and viewed as a metachronous new lesion.

CONCLUSIONS

Bronchial sleeve resection is a safe procedure for suitably located endobronchial carcinoid tumours. Endoscopic resection should be reserved for patients who decline, or are unfit, for surgery.

摘要

目的

支气管肺类癌是相对少见的原发性肺肿瘤。这些病变中有一小部分主要位于支气管内,未超出支气管壁。可进行内镜切除,但局部复发风险约为三分之一,因此需要长期监测。另一种选择是通过支气管成形切除术进行完整的手术切除。我们介绍我们对支气管内类癌患者进行手术切除的经验。

方法

2000年至2010年,13例患者(年龄45±16岁,男性10例)接受了单纯支气管成形切除术,包括系统性淋巴结清扫,用于治疗支气管内类癌肿瘤,未切除肺实质。

结果

无明显手术 morbidity 或死亡率。这是对连续病例系列的回顾性研究。所有患者的最后随访时间为2011年。肿瘤最大平均大小为18±8 mm。未观察到淋巴结侵犯。中位随访时间为6.3±3.3年,无区域复发。1例患者在5年后对侧气道发现一个小结节,被视为异时性新病变。

结论

支气管袖状切除术对于位置合适的支气管内类癌肿瘤是一种安全的手术方法。内镜切除应保留给拒绝手术或不适合手术的患者。

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