Late results of sleeve resection for typical bronchial carcinoids

The late follow-up was analyzed of 17 patients who underwent a sleeve resection for bronchial carcinoid tumor between 1974 and 1993. The mean age was 38 years (range 22-59). The bronchoplastic resections performed were sleeve lobectomy of the right upper lobe in six patients, sleeve lobectomy of the left lower lobe in three, sleeve resection of the right main bronchus in five and a sleeve resection of the left main bronchus in three patients. Only the pure sleeves are included and all other types of bronchoplastic resections (variant sleeves) for the same type of tumor were excluded. Preoperative laser therapy was applied in eight patients (from 1986 on). On surgical-pathologic staging, ten patients belonged to stage I (8T2N0M0 + 2T1N0M0), one patient belonged to stage II (T2N1M0) and six patients to stage IIIA (T3N0M0). There was no major perioperative morbidity and the hospital mortality was 0%. There were no local tumor recurrences but in one patient a bronchial stenosis at the site of the anastomosis needed a completion pneumonectomy after 16 months. The actuarial survival rate was 100% (+/- 0) at 5, 10 and 15 years. At 5, 10 and 15 years, 94% of the patients were free of major pulmonary events. This large series of bronchial carcinoids from one center treated by pure sleeve resection shows excellent short- and long-term results; therefore it seems to be justified to perform a sleeve resection for bronchial carcinoids when the tumor location and the surgeon's skill permit.