BRONŞİYAL KARSİNOİD TÜMÖRLERDE CERRAHİ TEDAVİ VE SONUÇLARI

Öz

Bronşial karsinoidler; trakeobronşial ağacın düşük dereceli malign nöroendokrin tümörlerindendir. Bütün bronş orjinli tümörlerin %0.5-2'sini oluştururlar. Cerrahi tedavi; bronkotomi yolu ile eksizyondan, pnömonektomiye kadar değişebilmektedir. Kasım 1995-Haziran 2003 tarihleri arasında opere edilen 10 karsinoid tümör olgusu, klinik özellikleri, uygulanan cerrahi tedavi ve sonuçları yönünden retrospektif olarak incelendi. Hastaların 5'i kadın, 5'i erkek olup, yaşları 23-66 (ortalama 43.2) arasında değişmekte idi. Lezyonların yerleşim yerleri; 3 olguda ana bronş, 2'sinde lob bronşu, 2'sinde periferik parankimal, 2'sinde segment bronşu ve 1 olguda ise "common" bazal segment bronşu içinde idi. Bütün olgular tipik karsinoid olarak bildirilmiş olup; biri bronşial sleeve lobektomi olmak üzere 5 olguya lobektomi, 3 olguya pnömonektomi, 1 olguya bronşial sleeve segmentektomi, 1 olguya ise wedge rezeksiyon uygulandı. Postoperatif komplikasyon 1 hastada görüldü. Mortalite izlenmedi. Olgularımız 4 ila 93 (ortalama 46.2 ay) ay takip edilmiş olup nüks gözlenmemiştir ve olguların tamamı yaşamaktadır. Günümüzde karsinoid tümörün tedavisinde, parankim harabiyeti olmadıkça sleeve rezeksiyon gibi parankim koruyucu yöntemler tercih edilmektedir. Genç yaşlarda sıklıkla görülen karsinoid tümörlerde uygulanan parankim koruyucu rezeksiyonlar, hastalara konfor ve yaşam kalitesi sağlamaktadır. Son yıllarda uygun vakalarda, daha az morbidite ve benzer sağkalım oranlarıyla major rezeksiyon yerine sleeve rezeksiyon uygulamayı tercih ediyoruz.

Anahtar Kelimeler

• Karsinoid tümör, cerrahi tedavi

SURGICAL TREATMENT AND RESULTS IN BRONCHIAL CARCINOID TUMORS

Abstract

Bronchial carcinoids are low grade malignant neuroendocrine tumors of tracheobronchial tree and comprise 0.5 to 2% of all pulmonary neoplasms. Surgical treatment ranging from bronchotomy-excision to pneumonectomy. We have reviewed surgically treated 10 cases of carcinoid tumors, between November 1995 and June 2003 years, in view to patient characteristics, surgical technique used and results in this retrospective study. There were 5 women and 5 men with a mean age of 43.2 (23-66). Localization of the lesions; are located main bronchus in three cases, lobar bronchus in two, peripheral parenchymal in two, segmental bronchus in two, and common basal segment bronchi in one. Postoperative diagnosis of all cases were reported typical carcinoid. We performed five lobectomy that was performed bronchial sleeve lobectomy in one case, three pneumonectomy, one bronchial sleeve segmentectomy, and one wedge resection. Postoperative complication was observed in one case without mortality. All patients were followed up 4 to 93 months and were alive, and disease free. At present, lung preserving operations that sleeve resections are the main aim of the surgery whenever feasible. Lung preserving operations that was performed widely seen at younger patients are achieved life quality for these patients. In recent years, we are prefering sleeve resection as much as possible cases because of low morbidity, and achieved the sample survival rates of more extended resections.

Keywords

• Carcinoid tumor, surgical treatment

Kaynakça

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