Videothoracoscopy in the diagnosis and treatment of mediastinal tumors / 中国微创外科杂志

ABSTRACT

Objective To explore the application of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of mediastinal tumors. Methods Thirty-four patients with mediastinal tumors underwent VATS from June 1995 to December 2002. The patients comprised 9 men and 25 women, with a mean age 43 9 years (16～74 years). Entered into the study there were 14 cases of thymoma (9 benign thymomas and 5 malignant), 6 cases of neurogenic benign tumors, 5 bronchogenic cysts, 4 teratomas, 2 pericardial cysts and 3 other conditions (metastatic carcinoma, lymphoma and hemangioma racemosum, respectively). Maximum diameter of the tumors ranged 3 5 cm to 6 cm, mean 4 5 cm. Operations were performed under general anesthesia, double lumen endotracheal tube placement and single lung ventilation. The patients were maintained in the lateral decubitus position. Camera port was placed at the sixth or the seventh intercostals space on the midaxillary line. Sites of the other two ports depended upon the location of the tumors. Results Out of the 34 patients with mediastinal tumors, 25 patients underwent tumor removal by VATS alone and 6 patients received VATS combined with mini-thoracotomy, while the remaining 3 patients only underwent biopsy by VATS. Postoperatively, all patients recovered uneventfully, without severe complications or mortality. Conclusions VATS is the first choice for benign mediastinal tumors, typically those in the middle and posterior mediastinum.