Video-assisted Thoracoscopic Surgery for Anterior Mediastinal Nodules:Report of 32 Cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the feasibility of video-assisted thoracoscopic surgery for anterior mediastinal modules. Methods Thoracoscopic surgery was performed with the patients in supine position and the thoracoscope set at 30?. Three trocars were used during the procedure. One of the trocars was inserted through the fifth or sixth intercostal space at the midaxillary line for direct observation. And the other two were placed at the second or third intercostal space at the midclavicular line,and the fifth intercostal space at the anterior axillary line. The nodules were removed directly during the operation. For inseparable nodules,the whole thymus and the fat tissues in the anterior mediastinum were removed all together. Results The procedure was completed under a thoracoscope in all of the 32 cases. Small assistant incision was made in 3 cases because of hemorrhage in the chest cavity. Postoperative pathological examination showed thymus tumor in 14 cases,hyperplasia of the thymus in 3,thymic cyst in 5,bronchial cyst in 3,pericardial cyst in 2,neurilemmoma in 2,lymph node in 2,and angioma in 1. The accordance rate of pre-and post-operative diagnosis was 68.8% (22/32). Postoperative complications were found in two patients,including one case of pericardial effusion,and one case of lung infection. Both the cases were cured afterwards. Conclusions Thoracoscopic surgery is a minimally invasive procedure for the treatment of anterior mediastinal nodules. It is optimal for young patients and cases with low lung function,as it causes less pain,quicker recovery,and satisfying cosmetic outcomes.