Complications associated with carotid body tumor excision

Gür, Ali Kemal

doi:10.5606/tgkdc.dergisi.2018.13614

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…Shamblin classification frequently used to define the pathology is based on its relation with the carotid arteries. [3] In Type 1, the tumor is in close proximity to the vessels. In Type 2, the carotid arteries are partially wrapped.…”

Section: Discussionmentioning

confidence: 99%

“…The first two are easier to remove from the vascular and neural structures, while the other may require vascular reconstruction. [3] In all, however, surgical intervention should be performed by an experienced surgeon who is familiar with all surgical procedures. In both cases presented herein, the internal and external carotid arteries were almost completely wrapped with the tumor, although there was no invasion to the arterial wall.…”

Section: Discussionmentioning

confidence: 99%

“…Vascular and cranial nerve damage due to dissection and retraction can be also seen. [3] Preoperative embolization is an effective method to reduce tumor vascularity and size. Herein, we report two adult cases who were treated surgically following selective embolization with the diagnosis of a unilateral carotid body tumor and discuss the effects of tumor embolization on surgery.…”

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confidence: 99%

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A unilateral carotid body tumor: A report of two cases

Ünlü¹

2019

Turk J Vasc Surg

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Carotid body tumors usually occur as painless mass in the neck and are quite vascular and slow-growing tumors. Diagnosis is based on Doppler ultrasound, computed tomography, magnetic resonance and angiography. Treatment is surgical resection. Cranial nerve damage, vascular injury and bleeding are the most common surgical complications. Selective tumor embolization can be performed preoperatively to reduce tumor vascularity and blood loss during resection. Herein, we report two adult cases presenting with unilateral asymptomatic masses in the neck who were diagnosed with a carotid body tumor and were treated surgically following selective embolization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A unilateral carotid body tumor: A report of two cases

Ünlü¹

2019

Turk J Vasc Surg

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“…Since these are highly vascularized tumors, surgical resection of CBTs remains challenging due to the substantial intraoperative bleeding during excision (2,3). Specifically, as the size of the CBTs and the amount of intraoperative bleeding increase, the likelihood of vascular and neurologic adverse events rises (3)(4)(5)(6)(7)(8). Preoperative transarterial embolization (pre-TAE) decreased the overall blood loss (BL) and improved visualization at surgery, thus facilitating tumor resection, which was first introduced by Schick et al in 1980 (9).…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of preoperative superselective embolization on carotid body tumor surgery: A 13-year single-center experience

Yuan

Chen

et al. 2022

Front. Oncol.

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PurposeThis study presented our 13-year experience managing patients with CBTs (carotid body tumors) and was aimed to investigate the impact of pre-TAE (preoperative transarterial embolization) on CBT surgical resection.MethodsThis retrospective study reviewed 169 surgically excised CBTs between May 2007 and October 2020. According to whether to carry out the pre-TAE, the patients were classified into the embolization (EG) (n = 130) and non-embolization groups (NEG) (n = 39). Tumor classification was based on Shamblin criteria and tumor size. The demographic data, clinical features, and intraoperative and postoperative information about the patients were retrieved and analyzed.ResultsThe average tumor size was (43.49 vs. 35.44 mm, p = 0.04) for EG and NEG. The mean surgical time (195.48 vs. 205.64 mins, p = 0.62) and intraoperative BL (blood loss) (215.15 vs. 251.41 cc, p = 0.59) were less, but the incidence of revascularization required (29% vs. 33%, p = 0.62) and total complications (26% vs. 36%, p = 0.32) were lower in EG compared to NEG. Similarly, according to the subgroup analysis, no significant differences were detected in the surgical time, BL, adverse events (AEs), and the revascularization in EG when compared to NEG for type I (n = 5 vs. 7), II (n = 105 vs. 27), and III (n = 20 vs. 5), respectively except for the surgical duration in type III (p < 0.05). However, a significantly lower incidence of AEs (230.25 vs. 350 cc, p = 0.038) and a decline in BL (28.57% vs. 48.15%, p = 0.049) in EG were observed compared to those in NEG patients for large CBTs (≥ 30 mm as the cutoff point). No surgery-related mortality was observed during the follow-up.ConclusionsCBTs can be surgically resected safely and effectively with a need for pre-TAE, which significantly decreases the overall BL and AEs for large lesions (≥ 30 mm).

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“…8 Depending on the size, extent and level of invasion into neighboring structures, resection of the tumor can lead to serious complications, 5 to the degree that if the tumor is over 5 cm, mortality rates can range as high as 1%-3% post-surgery 9 and there is a clear correlation between tumor size and morbidity of the cranial nerves, as well as cerebrovascular damage: the larger the carotid body tumor, the greater the morbidity of these structures. [10][11][12][13] A carotid body tumor classified as Shamblin II or III, that also surrounds the internal carotid artery wall, or that has less than 2 cm of space between the upper border of the tumor and the base of the skull, is considered especially difficult and complicated to resect. 3,14,15 In 2007, we began using a hybrid surgical technique 15 that allows us to resect these challenging carotid body tumors.…”

Section: Introductionmentioning

confidence: 99%

Two stage, hybrid endovascular and open surgical approach to treat difficult carotid body tumors

et al. 2022

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Objective Present the feasibility, applicability, clinical effectiveness, and results of complicated Shamblin II or III carotid body tumors treated with a two‐stage hybrid surgical approach. Materials and Methods Retrospective, observational, cross‐sectional, descriptive study of the successful treatment of 16 cases of difficult Shamblin II or III carotid body tumors, consisting of a two‐stage surgical approach. We conducted a retrospective, observational, cross‐sectional, descriptive study of a series of patients with complicated Shamblin II or III carotid body tumors, which we treated with a two‐stage hybrid surgical procedure, in which we first placed a carotid endoprosthesis and 45 days later performed surgical resection of the tumor, following our originally published technique. This study was conducted from February, 2007 to November, 2019, in a third level care centre. Results We treated 16 patients with a mean age of 50.5 years. All resided at more than 2000 meters above sea level. In all 16 a complete resection was performed. The average duration of surgery was 103.9 min, the average intraoperative bleeding was 69 ml. There were three cases of neuropraxia. The ansa cervicalis nerve had to be sectioned in three cases and there was permanent upper laryngeal nerve injury in two cases. There were no permanent cerebrovascular injuries from placement of the endoprostheses. One patient developed transient cerebral ischaemia (TIA) with no long‐term sequelae. There were two cases of asymptomatic late occlusion of the endoprostheses. The average initial volume of the tumors was 54.4 cc. The average tumor volume 35 days after implant of the endoprosthesis was 30.9 cc. Symptoms Presence of tumors in the neck in all cases and two cases of dysphagia. Conclusion This two‐stage hybrid technique allowed for the complete resection of difficult Shamblin II or III carotid body tumors, with one case of TIA and two with permanent upper laryngeal nerve injuries and without mortality.

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Complications associated with carotid body tumor excision

Cited by 9 publications

References 11 publications

A unilateral carotid body tumor: A report of two cases

A unilateral carotid body tumor: A report of two cases

Beneficial effects of preoperative superselective embolization on carotid body tumor surgery: A 13-year single-center experience

Two stage, hybrid endovascular and open surgical approach to treat difficult carotid body tumors

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