Brandt B, Heintz S E, Rose E F, Ehrenhaft J L
Ann Thorac Surg. 1984 Jul;38(1):63-5. doi: 10.1016/s0003-4975(10)62188-1.
Forty-six patients with bronchial carcinoid tumors were operated on over a 37-year period. The results were reviewed with special reference to presenting complaint, histological diagnosis, location of the tumor, lymphatic involvement, and type of surgical resection. Age at operation ranged from 9 to 86 years (mean, 43.6 years). Presenting symptoms were hemoptysis in 21 instances, chronic cough in 17, and pneumonia in 15. The primary tumor was within the main bronchus in 17 patients. Twenty-one patients required pneumonectomy, and 20 had lobectomy or bilobectomy . Nine of the patients under-going pneumonectomy had severely damaged lung tissue distal to the lesion in the main bronchus. Six patients had metastases to hilar nodes. Four patients died of carcinoid tumor, but none with metastases died of carcinoid tumor. This series confirms the low malignancy potential of bronchial carcinoid tumors, even in the presence of lymphatic involvement. Although conservative resection is an attractive surgical option, only 10 of the 46 (22%) were potential candidates for such intervention. Standard surgical resection resulted in "cure" in 90% of the patients in the series.
在37年的时间里,对46例支气管类癌患者进行了手术。对结果进行了回顾,特别参考了主诉、组织学诊断、肿瘤位置、淋巴结受累情况以及手术切除类型。手术年龄范围为9至86岁(平均43.6岁)。主诉症状为咯血21例,慢性咳嗽17例,肺炎15例。17例患者的原发肿瘤位于主支气管内。21例患者需要进行肺切除术,20例进行了肺叶切除术或双肺叶切除术。9例接受肺切除术的患者主支气管病变远端的肺组织严重受损。6例患者出现肺门淋巴结转移。4例患者死于类癌肿瘤,但有转移的患者无一死于类癌肿瘤。该系列证实了支气管类癌肿瘤的低恶性潜能,即使存在淋巴结受累情况。尽管保守切除是一种有吸引力的手术选择,但46例患者中只有10例(22%)可能适合这种干预。标准手术切除使该系列中90%的患者“治愈”。