BRONÞÝYAL KARSÝNOÝD TÜMÖRLERDE CERRAHÝ TEDAVÝ VE SONUÇLARI

Bronþial karsinoidler; trakeobronþial aðacýn düþük dereceli malign nöroendokrin tümörlerindendir. Bütün bronþ orjinli tümörlerin %0.5-2'sini oluþtururlar. Cerrahi tedavi; bronkotomi yolu ile eksizyondan, pnömonektomiye kadar deðiþebilmektedir. Kasým 1995-Haziran 2003 tarihleri arasýnda opere edilen 10 karsinoid tümör olgusu, klinik özellikleri, uygulanan cerrahi tedavi ve sonuçlarý yönünden retrospektif olarak incelendi. Hastalarýn 5'i kadýn, 5'i erkek olup, yaþlarý 23-66 (ortalama 43.2) arasýnda deðiþmekte idi. Lezyonlarýn yerleþim yerleri; 3 olguda ana bronþ, 2'sinde lob bronþu, 2'sinde periferik parankimal, 2'sinde segment bronþu ve 1 olguda ise "common" bazal segment bronþu içinde idi. Bütün olgular tipik karsinoid olarak bildirilmiþ olup; biri bronþial sleeve lobektomi olmak üzere 5 olguya lobektomi, 3 olguya pnömonektomi, 1 olguya bronþial sleeve segmentektomi, 1 olguya ise wedge rezeksiyon uygulandý. Postoperatif komplikasyon 1 hastada görüldü. Mortalite izlenmedi. Olgularýmýz 4 ila 93 (ortalama 46.2 ay) ay takip edilmiþ olup nüks gözlenmemiþtir ve olgularýn tamamý yaþamaktadýr. Günümüzde karsinoid tümörün tedavisinde, parankim harabiyeti olmadýkça sleeve rezeksiyon gibi parankim koruyucu yöntemler tercih edilmektedir. Genç yaþlarda sýklýkla görülen karsinoid tümörlerde uygulanan parankim koruyucu rezeksiyonlar, hastalara konfor ve yaþam kalitesi saðlamaktadýr. Son yýllarda uygun vakalarda, daha az morbidite ve benzer saðkalým oranlarýyla major rezeksiyon yerine sleeve rezeksiyon uygulamayý tercih ediyoruz.

SURGICAL TREATMENT AND RESULTS IN BRONCHIAL CARCINOID TUMORS

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.