ASPECTS OF DIAGNOSTICS AND VARIANTS OF SURGICAL TREATMENT IN CARCINOID TUMORS OF THE LUNGS

Actuality. The choice of optimal tactics for the diagnosis and treatment of patients with lung carcinoid of various localization currently remains an urgent problem. Purpose. Improving diagnostic and therapeutic tactics for lung carcinoid. Material and methods. An analysis of the medical documentation of 28 patients with different localizations of lung carcinoid for the period from 2009–2019 was performed. The patients underwent dynamic x-ray examination of the chest organs, computed tomography of the chest organs, as well as bronchoscopy with a biopsy of the tumor. However, only 5 (17.85%) patients received endoscopic verification of pathology. In 19 (67.86%) patients, carcinoid of central localization was diagnosed, and in 9 patients (32.14%) – that of peripheral localization. Results. Twenty-six (92.86%) patients underwent resection interventions. Lobectomy and bilobectomy on the right were performed in 15 (83.3%) and 3 (16.7%) cases, respectively. A total of 18 (69.23%) operations were performed on the right lung, and 8 (30.77%) lobectomies on the left one. All patients were discharged in satisfactory condition. When monitoring patients for up to 10 years of relapse, the transformation of carcinoid into small cell cancer was not observed. In all patients, neither at the time of diagnosis verification, nor in the distant postoperative period, metastasis to regional lymph nodes and target organs was detected. Conclusions. In the treatment of bronchial carcinoid of central localization, video-assisted anatomical resections of the lung or endobronchial minimally invasive interventions are preferred. With peripheral localization of the process, organ-saving resections using a surgical laser are preferred. An unfavorable prognosis for lung carcinoids is associated with indicators such as the size of the tumor node more than 3 cm, or high proliferative activity of tumor cells.