The Choice of Operation for Bronchial Carcinoids

Video-assisted thoracic surgery (VATS) lobectomy for typical bronchopulmonary carcinoid tumors

“…In the series of 12 cases reported here, the operation consisted of lobectomy in 11 cases and bilobectomy in one, and we performed the same type of excision that would have been carried out even in the absence video-endoscopic equipment. Although there is a tendency to treat typical carcinoids, especially peripheral ones, with limited resections [2,4,17], we consider lobectomy to be more reliable in cases in which respiratory function is normal, as has been reported by several other authors [1,10]. The cases reported here were treated in accordance with this principle; however, it must be noted that it would have been technically possible to perform a segmentectomy only in three cases of peripheral tumor.…”

“…However, at a mean follow-up of 30 months, no cases of carcinoid recurrence have been identified. On the subject of long-term results, we can nonetheless report that the effectiveness of pulmonary lobectomy is widely appreciated and its results are excellent [1,2,4,10]. If the proper selection criteria are followed, the use of VATS will not change these results because the extension of the resection is the same; the only variation is in the approach.…”

“…The first reported cases of carcinoids treated with video-assisted thoracic surgery (VATS) date back to 1996 [3,21], but an exact account of the criteria for the selection of cases that should undergo this treatment is still lacking. At present, traditional surgery for typical bronchopulmonary carcinoids, on the basis of specific indications, has achieved excellent results with a variety of techniques [1,2,4,5,10,17]: bronchial resection with bronchoplastic procedures, segmentectomy, lobectomy, and, in a few cases, even pneumonectomy. Moreover, in particular situations, it has now been proposed that excision of the tumor can be done by means of bronchoscopy [18].…”

Bronchial Carcinoids

“…Primary lesions are treated with surgical resection [29], These tumors benefit from a conservative resection [30], When the tumor is located at major bronchi, including lobar bronchi, conservative resection with bronchoplastic techniques is the therapy of choice [26]. The peripheral site or extension of the tumor, the parenchymal destruc tion (atelectasis, bronchiectasis, pneumonitis, obstructive emphysema) caused a long delay in tumor evolution [13,16], pulmonary parenchymal resections, with lobectomy being more common (55%), are performed [20,25].…”

Focus on treatment of lung carcinoid tumor

“…Parenchyma-saving resections should be preferred for a typical carcinoid tumor 7. Patients who have an atypical carcinoid tumor with a consequent higher rate of nodal involvement should receive a radical surgery 6,8. Published in 2010, a retrospective study of 126 patients treated surgically for a carcinoid tumor showed that the survival at 10 years was 79.8%.…”