Use of 3-dimensional computed tomography for planning a complex sleeve bronchoplasty with total parenchyma-sparing resection of a carcinoid tumour in the right main bronchus

Abstract

Bronchoplasty is frequently required for radical resection of central typical carcinoid tumours. As sleeve bronchoplasty can be a complex procedure, an accurate evaluation of the tumour location is mandatory. Although the endobronchial part of the tumour can be easily evaluated by bronchoscopy, the exo-bronchial part is difficult to analyse with a standard computed tomography (CT) scan. A three-dimensional (3D) CT scan could be used to identify this exo-bronchial component of the tumour when planning a reconstruction. Herein, we present a case of a 59-year-old woman with a typical central carcinoid tumour of the right main bronchus. After 3D modelling, we successfully performed a total parenchyma-sparing resection with an intermedius bronchus reimplantation into the carina associated with the right upper bronchus anastomosis in the lateral trachea. The follow-up was uneventful. An endoscopy at 3 months showed excellent results.

Carinal resection and reconstruction with complete pulmonary parenchyma preservation: a single-institution analysis of 36 cases

“…Previous studies have reported perioperative and survival outcomes of carinal resection combined with different degrees of lung resection (7)(8)(9). For lesions confined to the carina or carinal lesions involving the lower trachea, isolated carinal resection without sacrificing lung parenchyma has only been summarized in case reports or in studies involving a limited sample size (12,(24)(25)(26). Regnard et al reviewed 65 cases of carinal surgeries for malignancies spanning 19 years and found that only 5 patients underwent carinal resection without lung resection (10).…”

Neuroendocrine syndrome in bronchial carcinoid tumors

“…In our study, bronchial carcinoid tumors were more often found in male patients rather than in female patients, as opposed to data found in literature. Location of bronchial carcinoids in 75% of cases is in the main respiratory tract (12).…”

Auditorium of the future: e learning platform

“…An average of 1.35 (0.18-3.5) hours were spent for each course and 6.4 (2.75-9.5) hours for the four courses. Residents passed each quiz after a mean of 2.86 [1][2][3][4][5][6][7] attempts. Overall courses were found to be easy to navigate; courses, multimedia content and quizzes were beneficial in learning content (3).…”

“…Three-dimensional planning and printing are also becoming tools for pre-operative planning and anatomical understanding. There are several reports of using these technologies in apical tumors, tumors with vertebral invasion, chest wall invasion and tracheobronchial reconstruction (5)(6)(7)(8). In a very recent study that involved 16 patients who underwent video-assisted thoracoscopic surgery (VATS) lobectomy, preoperative 3D printing of pulmonary hilum was found to be the most accurate to show the variations of hilar vessels (5).…”

“…Another case report was on a very difficult patient with right main bronchus carcinoid tumor that required resection and reconstruction of carina and right main bronchus. 3D CT scan reconstruction allowed accurate recognition of extra-bronchial extent of the tumor and there was a correlation between preoperative and intra-operative findings (6). In another study on chest wall resection and reconstruction, 3D planning and printing technology was applied for primary chest wall tumors and lung cancers with chest wall involvement (7).…”