Surgical treatment for tracheobronchial carcinoid tumors: a 16-year experience

We conducted a 16-year retrospective review of 31 cases of tracheobronchial carcinoid tumors treated in our institution between 1995 and 2011, to determine their characteristic features and outcome of management. There were 12 men and 19 women. The most common presenting symptoms were cough and hemoptysis (71%) with a mean duration of 4 years. Preoperative bronchoscopy confirmed the diagnosis in 80% of patients. Right-sided tumors accounted for 60% of cases. Most tumors arose from the mainstem bronchi. Histologic analysis revealed typical carcinoids in 28 cases and atypical carcinoids in 3. Surgical treatment was mainly radical resection (pneumonectomy in 19 patients). A parenchymal-preserving surgery (sleeve resection of left main bronchus and end-to-end anastomosis) was only possible in 2 cases. Mediastinal lymph nodes were involved in 30% of cases. Most patients had widespread extraluminal extension. Follow-up revealed recurrence in one patient. No deaths were recorded, and complications were mainly atelectasis and air leak. Radical resection remains the mainstay of surgical management of bronchial carcinoids in cases of late presentation with destroyed and bronchiectatic distal pulmonary parenchyma. Parenchymal-preserving surgery should only be carried out when indicated.