Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > Articles online first > The Journal of Cardiovascular Surgery 2019 Oct 04

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

 

The Journal of Cardiovascular Surgery 2019 Oct 04

DOI: 10.23736/S0021-9509.19.10496-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Carotid body tumor contemporary management in a high-volume centre

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

1 Vascular Surgery Unit, Scientific Institute San Raffaele Hospital, “Vita-Salute” University School of Medicine, Milan, Italy; 2 Vascular Surgery Unit, “A. Gemelli” University Hospital, Catholic University of Sacred Heart School of Medicine, Rome, Italy


PDF


BACKGROUND: The aim of this study is to report our results with carotid body tumour (CBT) surgical management.
METHODS: Between 2010 and 2018, 100 CBTs (mean age: 48.0 years, range 21-80 years old) were treated in our centre. The patients were classified in 3 groups according to the size: group I (< 3cm), 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 tumour size is to be considered a risk factor for CNI because large CBTs remain at high risk for CNIs.


KEY WORDS: Carotid body tumor; Paragangliomas; Surgical treatment; Vascular complication; Cranial nerve injury

inizio pagina