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

Background: Indications for the use of video-assisted thoracic surgery (VAT S) lobectomy are a controversial matter. This study aims to provide a retro spective evaluation of VATS lobectomy in typical bronchopulmonary carcinoid s. Methods: Patient selection criteria for VATS lobectomy were as follows: (a) typical carcinoids with clear diagnosis; (b) centrally located lung tumors not amenable to bronchial resection with bronchoplastic procedures, or tum ors located in peripheral lung tissues; (c) no hilar or mediastinal lymph n ode enlargement; and (d) normal respiratory function. Between January 1995 and December 1999, 12 patients (eight men and four women with a mean age of 57 years) were treated, seven with a peripheral and five with a centrally located tumor. Preoperative examination included chest roentgenograms, comp uted tomography (CT) of the chest, bronchoscopy, and spirometry; diagnosis was established by direct bronchoscopy in dye cases, transbronchial biopsy in two cases, transthoracic biopsy in two cases, and video-thorascopic wedg e resection in three cases. Eleven VATS lobectomies and one VATS bilobectom y were performed. All patients underwent hilar lymphadenectomy and mediasti nal sampling. Results: There were no intraoperative complications. The only postoperative complication, hematothorax (8.3%), required VATS reoperation. Mean postope rative hospital stay was 5.33 days. Pathological examination of the resecte d specimens confirmed that the procedure was radical in all 12 patients and revealed eight T1N0 and four T2N0. At a mean follow-up of 30 months, no si gns of recurrence were recorded. Conclusion: VATS lobectomy in the treatment of selected typical carcinoids, both central and peripheral, seems to yield favorable results and is there fore preferable to thoracotomy since it is less invasive.