Our Parenchyma-Sparing Surgical Treatment Results in Carcinoid Tumors and Changes in the Surgical Approach

Abstract

INTRODUCTION: Hilar/mediastinal lymph node sampling with lobectomy are the most common surgical methods used for the surgical treatment of carcinoid tumors. Bronchoplastic approaches together with lobectomy enable sparing of normal lung tissue and provide an alternative surgical approach to avoid pneumonectomy by enabling sleeve resection for centrally located tumors. The aim of this study was to present our parenchyma-sparing open surgical treatment experiences with the carcinoid tumor cases operated in our clinic in light of the new developments in the literature METHODS: The 11 tumor cases that had been diagnosed with carcinoid tumor and undergone surgical resection at our clinic between 2006 and 2012 were retrospectively revealed for tumor epidemiology, diagnostic methods, tumor localization, surgical treatment method, type and stage and postoperative complications. RESULTS: There were 7 males and 4 females with a mean age of 54.81±13.75 years (31-72 years). Cough was the most common presentation symptom with 8 cases (72.7%). A bronchoscopic biopsy was used for the definite diagnosis in 8 cases (72.7%). There were 11 (84.6%) typical and 2 (15.4%) atypical carcinoid tumors in the 11 cases. The most common surgical methods were lobectomy in 7 cases (53.8%) (3 sleeve, 1 bronchoplastic) and wedge resection in 4 cases. We found bilateral synchronous and 3 years later metachronous carcinoid tumor in a single case. The postoperative pathology diagnosis was T2N0M0 in 6 cases (54.5%) and T1N0M0 in 3 cases (27.2%). There was 1 atelectasis and 1 prolonged air leak in the postoperative stage. DISCUSSION AND CONCLUSION: Although we still use thoracotomy and lobectomy for the surgical treatment of carcinoid tumors in our clinic, we currently prefer minimal invasive surgery with the VATS and robotic surgery techniques that are gradually becoming more popular.