Indication and procedure of Video-assisted thoracic surgery (VATS) for mediastinal tumor.

Muraoka Masashi, Oka Tadayuki, Akamine Shinji, Tagawa Tsutomu, Nagayasu Takeshi, Ikuta Yasushi, Inoue Masao, Tagawa Yutaka, Ayabe Hiroyoshi

doi:10.2995/jacsurg.17.8

We retrospectively reviewed the video-assisted thoracic surgery (VATS) approach for mediastinal tumor in our institution. Forty-one patients (16 males and 25 females aged 18 to 74 years) underwent VATS for resection of mediastinal tumors from 1992 to 2001. These cases included 6 thymomas, 6 thymic cysts, 12 neurogenic tumors, 7 bronchogenic cysts, 2 pericardial cysts, 2 teratomas, and 6 others. Seventeen tumors were located in the anterior, 8 in the middle, 13 in the posterior, and 3 in the superior mediastinum. The average tumor diameter was 4.6cm. In 20 patients, the resection was completed thoracoscopically; in 16, a small incision was performed for a minithoracotomy to assist the thoracoscopic procedure, andincisional biopsies were performed in 2. Conversion to thoracotomy was required in 3 cases. The mean number of surgical access ports was 3.1, andthe average operating time was 176±76 minutes. Intraoperative bleeding (114±214g), chest tube insertion period (1.2±0.8days), and postoperative hospital stay (8.0±4.1days) were significantly lower than in cases resected by median-sternotomy. Although post-operative complications occurred in 3 cases (7.3%), there was no post-operative death within 30 days. We concluded that VATS for mediastinal tumors is a less invasive and safer approach, and it is possible to resect mediastinal tumors in any location by VATS. However, we should limit the indication of this procedureto malignant tumors including invasive thymoma.

Indication and procedure of Video-assisted thoracic surgery (VATS) for mediastinal tumor.

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