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

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.

Keywords: Bronchoplastic resection; Carcinoid; Endobronchial; Sleeve resection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bronchial Neoplasms / pathology
  • Bronchial Neoplasms / surgery*
  • Carcinoid Tumor / pathology
  • Carcinoid Tumor / surgery*
  • Female
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pulmonary Surgical Procedures / adverse effects
  • Pulmonary Surgical Procedures / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Tumor Burden
  • Young Adult