Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 2020 August;61(4) > The Journal of Cardiovascular Surgery 2020 August;61(4):459-66

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLE  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2020 August;61(4):459-66

DOI: 10.23736/S0021-9509.19.10496-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Carotid body tumor contemporary management in a high-volume center

Daniele MASCIA 1 , Gloria ESPOSITO 1, Angela FERRANTE 2, Alessandro GRANDI 1, Germano MELISSANO 1, Roberto CHIESA 1

1 Unit of Vascular Surgery, San Raffaele Hospital IRCCS, Vita-Salute San Raffaele University, Milan, Italy; 2 Unit of Vascular Surgery, A. Gemelli University Polyclinic, Sacred Heart Catholic University, Rome, Italy



BACKGROUND: The aim of this study is to report our results with carotid body tumor (CBT) surgical management.
METHODS: Between 2010 and 2018, 100 CBTs (mean age: 48.0 years, range 21-80 years old) were treated in our center. The patients were classified in 3 groups according to the size: group I (<3 cm), group II (3 to 5 cm) and group III (>5 cm).
RESULTS: Surgical resection was performed in 88 patients and conservative treatment in 2 cases. Nine patients were treated for bilateral involvement and one of them was also treated again for a relapse. Postoperatively, cranial nerve injury (CNI) was significantly higher in group II [3 (8.3%) vs. 16 (31.4%) vs. 2 (15.4%); P=0.030] with no statistical differences between the CN involved. At univariate analysis for CNI, CBT group (P=0.030), maximum diameter (P=0.046), patients presenting with dysphonia (P=0.035) and dysphagia (P=0.007) and patients suffering from any intraoperative complication (P=0.047) were statistically significant. At multivariate analysis the only significant variable was CBT group II (P=0.016). For blood loss, CBT group III (P<0.001), Shamblin class III (P<0.001), Pulmonary disease (P=0.034) and surgery time (P<0.001) were statistically significant. The follow-up of 79 patients (87.8%) showed a 100% overall survival at median follow-up of 37.7 months (range 2-84.7 months) with freedom from local recurrence of 97.8% (77/79).
CONCLUSIONS: Surgical resection remains the gold standard to obtain complete recovery, although tumor size is to be considered a risk factor for CNI because large CBTs remain at high risk for CNIs.


KEY WORDS: Carotid body tumor; Paraganglioma; Surgical procedures, operative; Cranial nerve injuries

inizio pagina