Schepens M A, Van Schil P E, Knaepen P J, Van Swieten H A, Brutel de la Rivière A
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Eur J Cardiothorac Surg. 1994;8(3):118-21. doi: 10.1016/1010-7940(94)90165-1.
The late follow-up was analyzed of 17 patients who underwent a sleeve resection for bronchial carcinoid tumor between 1974 and 1993. The mean age was 38 years (range 22-59). The bronchoplastic resections performed were sleeve lobectomy of the right upper lobe in six patients, sleeve lobectomy of the left lower lobe in three, sleeve resection of the right main bronchus in five and a sleeve resection of the left main bronchus in three patients. Only the pure sleeves are included and all other types of bronchoplastic resections (variant sleeves) for the same type of tumor were excluded. Preoperative laser therapy was applied in eight patients (from 1986 on). On surgical-pathologic staging, ten patients belonged to stage I (8T2N0M0 + 2T1N0M0), one patient belonged to stage II (T2N1M0) and six patients to stage IIIA (T3N0M0). There was no major perioperative morbidity and the hospital mortality was 0%. There were no local tumor recurrences but in one patient a bronchial stenosis at the site of the anastomosis needed a completion pneumonectomy after 16 months. The actuarial survival rate was 100% (+/- 0) at 5, 10 and 15 years. At 5, 10 and 15 years, 94% of the patients were free of major pulmonary events. This large series of bronchial carcinoids from one center treated by pure sleeve resection shows excellent short- and long-term results; therefore it seems to be justified to perform a sleeve resection for bronchial carcinoids when the tumor location and the surgeon's skill permit.
对1974年至1993年间接受支气管类癌肿瘤袖状切除术的17例患者进行了后期随访分析。平均年龄为38岁(范围22 - 59岁)。所进行的支气管成形切除术包括6例右上叶袖状肺叶切除术、3例左下叶袖状肺叶切除术、5例右主支气管袖状切除术和3例左主支气管袖状切除术。仅纳入单纯袖状切除术,排除同一类型肿瘤的所有其他类型支气管成形切除术(变异袖状切除术)。8例患者(从1986年起)术前接受了激光治疗。手术病理分期方面,10例患者属于I期(8例T2N0M0 + 2例T1N0M0),1例患者属于II期(T2N1M0),6例患者属于IIIA期(T3N0M0)。围手术期无严重并发症,医院死亡率为0%。无局部肿瘤复发,但1例患者在吻合口处出现支气管狭窄,16个月后需要行全肺切除术。5年、10年和15年的精算生存率为100%(±0)。在5年、10年和15年时,94%的患者无重大肺部事件。该来自一个中心的大量支气管类癌患者系列经单纯袖状切除术治疗显示出优异的短期和长期结果;因此,当肿瘤位置和外科医生的技术允许时,对支气管类癌进行袖状切除术似乎是合理的。