Bronş Adenomları ve Cerrahi Tedavi Yöntemleri

Year 1975, Volume: 28 Issue: 1-2 , 523 - 544 , 30.06.1975

Şinası Yavuzer

https://izlik.org/JA94RS46UB

Abstract

Bronş adenomlarına ait 10 karsinoid, 1 mikst tümör, 1 de mikst tipte bronş adenomu olmak üzere 12 vak'a incelemeye tabi tutuldu,
1— Vakalarımızda yaş ortalaması; 30, kadın erkek oranı 3/9 olarak tesbit edildi.
2 — Vak'alarımızdaki semptomların çoğunu öksürük, hemop- tizi ve balgam teşkil etmektedir.
3 — 12 vak'ada preoperatif bronkoskopi ve biyopsi ile kesin tanı oranı %91'dir
4 — Vakaların hepsi santral lokalizasyonlu idi. Radyolojik bulgular spesifik değildi.
5.— 12 vakanın inde tümörün distalinde bronşektazi, apse, pnömoni, ampiyem gibi infektiv olaylar oluşmuştu.
6 — Cerrahi yöntem olarak 7 vakada sleeve, bronkotomi: ve sleeve -lobektomi gibi konservatif prosedürler uygulandı. 4
vakaya lobektomi, 1 vakaya torakotomi yapıldı.
a) Tümörün lokalize olduğu, distal irreversibl infeksiyonun
olmadığı vak'alarda sleeve rezeksiyon uygulandı.
b) Distal irreversibl injeksiyonun bulunduğu, tümörün yaygın olduğu vak'alara lobektomi -sleeve veya sadece lobektomi
yapılaı.
c) Tümör pediküllü olduğu zaman bronkotomi ve eksizyon
yapıldı.
7 — Vakaların takiplerinde; 5 vak'a 9-11 senedir asemptomatiktir, 5 vaka asemptomatiktir, fakat henüz 5 seneyi doldurmamıştır. Bir vak'a unresectable bulunmuş ve 3 sene sonra Ölmüştür. Diğer 1 vaka takipsiz kalmıştır.
8 — Vakaların hepsine kontrollarda bronkoskopi, bazılarına
bronkografi yapılarak nüks ve stenoz olmadığı saptanmıştır.

Keywords

Bronş Adenomu , Karsinoid Tümör , Cerrahi Tedavi

BRONCHIAL ADENOMAS AND SURGICAL TREATMENT METHODS

https://izlik.org/JA94RS46UB

Abstract

Twelve cases of bronchial adenomas were examined: 10 carcinoids, 1 mixed tumor, and 1 mixed-type bronchial adenoma.

1— The average age of our cases was 30, and the female-to-male ratio was 3/9.

2— The majority of the symptoms in our cases included cough, hemoptysis, and sputum production.

3— The definitive diagnosis rate with preoperative bronchoscopy and biopsy was 91% in 12 cases.

4— All cases were centrally located. Radiological findings were nonspecific.

5— Infective events such as bronchiectasis, abscess, pneumonia, and empyema occurred distal to the tumor in 12 cases.

6— Conservative surgical procedures such as sleeve bronchotomy, and sleeve lobectomy were performed in 7 cases. Four cases underwent lobectomy, and one underwent thoracotomy.

a) Sleeve resection was performed in cases where the tumor was localized and there was no distal irreversible infection.

b) Lobectomy, sleeve, or lobectomy alone was performed in cases where there was distal irreversible infection and the tumor was widespread.

c) Bronchotomy and excision were performed when the tumor was pedicled.

7 — In the follow-up of the cases, 5 cases have been asymptomatic for 9-11 years, and 5 cases have been asymptomatic but have not yet completed 5 years. One case was found to be unresectable and died 3 years later. Another case was lost to follow-up.

8 — Bronchoscopy was performed in all cases during follow-up, and bronchography was performed in some cases, and no recurrence or stenosis was detected.

Keywords

Bronchial Adenoma , Carcinoid Tumor , Surgical Treatment

References

• 1 — Akhtar, M., Young, I., Reyes, F.: Bronchial Adenoma with Polymorphous Features. Cancer, 383 : 1572, 1974.
• 2 — Anderson, W. A. D.: Pathology. C. V. Mosby Co. St. Louis, P. 966 - 980, 1971.
• 3 — Andrews, M. F,, Pearson, F. G.: The Relation of the Bronchial Arterial Circulation and other Factors to the Translent Defect in Oxygen Uptake Following Auto - transplanlalion of the Canin Lung. Can. J. Surg, 16:1, 1978;
• 4 — Baldwin, J. N., Grimes, O. F.:; Bronchial Adenomas. Surg. Gynec, Obst., 124 :813, 1967.
• 5 — Bensch, K. G,, Gordon, G. B,, Miller, L. R.: Electron Micruoscope and Biochemical Studies on the Bronchial Carcinold 'Tumors. Cancer, 18: 592, 1965.
• 6— Blades, B.: Bronchial Adenomas. In Surgical Diseases of the Chest. C. V. Mosby Co. Sain Louis, 3. Ed. P. 160, 1974.
• 7-Bradshaw, H. H., Shaffner, L. D.: Deaton, W.R.: Bronchial Adenoma, A Case Report. J. Thoracic. Surg, 23 : 388, 1952.
• 8-Donahue, J. K., Weichert, R. F., Oshsner, J. J.: Bronchial Adenoma. Ann. Surg., 167 :873, 1968.
• 9-Gebauer, P. W.: Pulmonary Surgical Salvage by Bronchial Resection, Surg. Gynec. Obst., 94:347, 1952.
• 10-Gibbon, H. J.: Bronchial Adenoma. In Surgery of the Chest. W. B, Saundress Co. 2. Ed. Philadelphia, P. 441, 1969.
• 11-Goodner, J. T., Berg, JI. W., Watson, W. L.: The Nonbenign Nature of Bronchial Carcinoids and Cylindromas. Cancer, 14:539, 1961.
• 12-Graham, E. A., Womack, N. A.: The Problem of So -Called Bronchial Adenoma. J. Thoracic Surg., 14: 106, 1945.
• 13-Hadju, S&. 1, et al.: Carcinoid Tumors. A Study of 204 Cases. Am. J. Clin. Pathol., 61:521, 1974.
• 14-Hinshaw, H. C.: Bronchial Adenoma and Other Intrathoracic 'Tumors. In Diseases of the Chest. W. B. Saunders Co. Philadelphia 3. Ed., P. 422, 1969.
• 15-Jensik, R. J., Faber, L. P., Brown, C. M., Kittle, C. E.: Bronchoplastic and Conservative Rescctional Procedures for Bronchial Adenoma. J. Thoracic. Cardiovasc. Surg., 68 : 556, 1974.
• 16-Markel, S. F., Abell, M. R., Haight, C., French, A. J.: Neoplasms of Bronchus Commoniy Designated as Adenomas. Cancer, 17:590, 1964.
• 17 — Mathey, J., Evrard, C., Neveux, J. Y.: Principes Gen&raux de la Chirurgie Trach&o - bronchigue. Encylopödie Med. Chir. Paris, P. 42136, 1970.
• 18-Me Burney, R. P,, Kirklin, J. W., Woolner, L. B. : Metastasizing Bronchial Adenomas. Surg. Gynec. Obst., 96 : 482, 1953.
• 19-Overholt, R. H., Bougas, J. A., Morse, D. P.: Bronchial Adenoma -A Study of 60 Patients with Resections. Am. Rev. Tub. and Pulm. Dis, 75 : 865, 1951.
• 20-Paulson, D. L., Ginsberg, R. J.: Bronchial Adenoma. In General Thoracic Surgery. Ed. Shields, T. W.. Lea Febiger, Philadelphia, P. TT4, 1972.
• 21-Payne, W. S., Schier, J., Woolner,L.B.: Mixed Tumors of the Bronchus - Salivary Gland Type -J. Thoracic Cardiovasc. Surg., 49 : 663, 1965.
• 22-Reid, J. D.: Adenoid Cystic Carcinoma (Cylindromatous Type) of the Bronchial Tree. Cancer, 5 : 685, 1952.
• 23-Robbins, $. L.: Pathologic Bases of Diseas. W. B. Saunders Co. Philadelphia, P. 839, 1974.
• 24-Stout, A. P.: Cellular Origin of Bronchial Adenoma. Arch. Path, 35: 85, 1943.
• 25-Toker, C. : Observation on the Ultrastructure of a Bronchial Adenoma - Carcinojd Type - Cancer, 19 : 1943, 1966.
• 26-Tolis, G. A., Fry, W. A., Head, L., Shields, T. W.: Bronchial Adenomas.Surg. Gynec. Obst., 134:605, 1972.
• 27-Verska, J. J., Connolly, J. E.: Bronchlal Adenomas in Children. J. Tho, Cardiov. Surg., 55:411, 1968,
• 28-Vincent, T. N., Satterfied, J. V., Ackerman, L. V.: Carcinoma of the Lung in Women. Cancer, 18 : 559, 1965,
• 29-Watson, W. L.: Lung Cancer. A Study of Five Thousand Memoral Hospital Cases. C. V. Mosby. Co. St. Louis, 1968.
• 30-Weiss, L., Ingram, M.: Adenomatold Bronchlial Tumors, Consideration of Carcinoid Tumors and Salivary Gland Tumors of Bronchial Tree. Cancer, 14:161 (1961.
• 31-Welborn, M. B, Jr., Fahmy, A., Gobbel, W. G. Jr.: Mucoepidermold Carcinoma of Bronchus with Chondrold Metaplasia and Elevated 5 - hydroxyindoleacetic acid excretion. J. Thoracic Cardlovasc. Surg,, 57 : 618, 1969.
• 32-Wessler, H., Rabin, C. B. : Benign Tumors of the Bronchus. Am. J. Med. Sci., 83 : 164, 1932.
• 33-Wilkins, W. E. Jr. Darling, R. C., Soutter, L., Sniffen, GC. R.: A Continuing Clinical Survey of Adenomas of the Trachea and Bronchus in a General Hospital. J. Thoracic Cardiovasc. Surg., 46:279, 1963.
• 34-Wood, P. B., Gilday, D., lives, R., Rae, &., Pearson, F. G.: A Comparison of Gas Exchange after Simple Lobectomy and Lobectomy with Sleeve Resection in Dogs. J. Thoracic Cardiovasc. Surg., 68 : 646, 1974.