Sleeve resection for bronchial carcinoid tumour in two children under six years old

Abstract

BackgroundPaediatric tracheobronchial tumours are very rare, and pneumonectomy and lobectomy procedures are rarely indicated due to their surgical difficulties and high sequelae. Bronchoplastic techniques preserving lung parenchyma allow the resection and reconstruction of the main bronchi and carina.Case PresentationHere, we present a 6-year-old boy suffering from a carcinoid tumour of the right main bronchus which was successfully managed with a right upper sleeve lobectomy and a 4-year-old girl with an endobronchial carcinoid tumour narrowing the left main bronchus that received a sleeve resection of that bronchus.ConclusionBronchoplastic techniques are widely used in adults, can be very successful in paediatric patients where the preservation of the lung parenchyma is more important.

Pediatric airway tumors: A report from the International Network of Pediatric Airway Teams (INPAT)

“…In particular, the treatment of choice in cases of infiltrative laryngotracheal tumors was single‐stage laryngotracheal reconstruction, whereas in cases of tracheobronchial involvement, parenchyma‐sparing surgical approaches such as sleeve resections and bronchoplasties were considered mandatory to prevent respiratory and functional sequelae …”

“…To date, most of the literature comprises case reports or case series that mainly focus on each histological subtype …”

“…1,[4][5][6]8,10,17 To date, most of the literature comprises case reports or case series that mainly focus on each histological subtype. 3,[6][7][8][9][10][12][13][14][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Because specific pediatric oncologic guidelines on preoperative workup, treatment, and follow-up are still lacking, the International Network of Pediatric Airway Teams (INPAT) has coordinated a large international cohort of PTT in children, including the entire Italian cohort collected by the Tumori Rari in Età Pediatrica (TREP) (Rare Tumors in Children), with a total of 14 institutions to provide a complete overview with regard to clinical presentation, diagnostic assessment, histological findings, and outcomes. Particular attention has been given to identifying the main prognostic factors, possibly influencing outcome and carefully evaluating treatment modalities.…”

Tracheal and bronchial tumors

“…In order to prevent later functional limitations, normal lung tissue must be spared as much as possible. Although pneumonectomies and lobectomies have been typically performed for bronchial tumours, parenchyma-saving procedures, such as sleeve resections and bronchoplasties, are the main procedures performed recently (28). Bronchial carcinoid and mucoepidermoid carcinoma are reported to metastasize to the lymph nodes so that their biopsy is strictly recommended (14,24,29).…”

Bronchial carcinoid in anomalous right upper bronchus: a “patient-tailored” bronchoplasty resection technique

“…Sleeve bronchoplasty techniques are complex surgical procedures defined as parenchyma-saving because they allow a radical resection with tumor-free margins while preserving the maximum amount of parenchyma (5). Bronchoplasty is particularly challenging in case of bronchial carcinoid arising from an anomalous bronchial tree and requires careful preoperative evaluation and adequate surgical skills.…”