Impact of Radiological Predictors on Surgical Management and Outcomes of Carotid Body Tumour Resection
Abdelrahman Salah Elsobhy Mohamed MBBS, MSc1,3*, Mahul Patel MD, MRCS2*, Mohammed Salah Elsobhy Mohammed MBBS4 and Romany Esshak Attalla Ghobrial MBBS, MSc, MD, MRCS1
1 Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
2 Surgical Emergency Unit, John Radcliffe Hospital, Oxford, United Kingdom.
3 Department of General Surgery, Royal Hampshire Country Hospital, Winchester, United Kingdom.
4 Department of General Surgery, Lister Hospital, Stevenage, United Kingdom.
*Corresponding Author: Abdelrahman Mohamed, Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt and Department of General Surgery, Royal Hampshire Country Hospital, Winchester, United Kingdom.
DOI: https://doi.org/10.58624/SVOAMR.2024.02.013
Received: June 23, 2024 Published: July 10, 2024
Abstract
Background: Carotid body tumours (CBTs) are rare, highly vascular tumours that arise from the paraganglion cells of the carotid body chemoreceptor organ, located near the carotid arteries bifurcation. CBTs cause a slow-growing mass in the neck region. This work aimed to plan a radiological-based surgical approach, assess for predictive factors of vascular reconstruction, the technique and types of vascular graft implemented and analyse outcomes following surgical intervention.
Methods: This retrospective, observational cohort study was conducted on 20 patients over 15 years who underwent resection of CBTs and were further categorised into whether they underwent vascular reconstruction or not. Radiological predictors were evaluated including the tumour size, location, vascularity, and proximity to adjacent structures. Data was analysed intraoperatively and postoperatively to investigate for complications.
Results: The majority of our patients were Male with an average age of 40, presenting with neck swelling. A total of 85% of patients were classed as 3 on the Shamblin Classification indicating extensive disease. The mean operation duration of the studied cases was 5.35±1.46hours and the mean blood loss was 1320±1044.59 mL. There were 3 (15%) cases that required vascular reconstruction of internal carotid artery using grafts and 2 (10%) cases were successfully controlled by primary vessel repair. We encountered high rates of intraoperative and postoperative complications confounded by the complex anatomical and physiological nature of the tumour.
Conclusions: Pre-operative imaging can help identify the location and extent of the tumour, which can guide the selection of surgical approach to reduce the risk of complications. Despite adequate planning, our study highlights the need for thorough patient education directed towards intra- and postoperative complications and morbidity. Emphasis should be placed on appropriate patient selection.
Keywords: Radiological, Predictors, Carotid Body Tumor, Resection, Vascular Reconstruction.
Citation: Mohamed A.S, Patel M, Mohamed M.S, Ghobrial R.E. Impact of Radiological Predictors on Surgical Management and Outcomes of Carotid Body Tumour Resection. SVOA Medical Research 2024, 2:2, 23-29. doi:10.58624/ SVOAMR.2024.02.013