Thoracoscopic resection of foregut duplication cysts

Area of Science:

• Thoracic surgery
• Gastrointestinal surgery
• Pediatric surgery

Background:

• Foregut duplications are rare congenital anomalies, encompassing esophageal and bronchogenic cysts.
• Diagnosis often results from incidental radiographic findings or symptoms like respiratory compromise due to mass effect or infection.
• Complete resection is the standard treatment to prevent recurrence.

Purpose of the Study:

• To evaluate the safety and efficacy of thoracoscopic resection for foregut duplication cysts.
• To assess outcomes and complications associated with this minimally invasive approach.

Main Methods:

• Retrospective review of six patients undergoing thoracoscopic resection of foregut duplication cysts between May 1998 and April 2003.
• Procedures utilized three to four ports, with single lung ventilation in some cases.
• One patient required conversion to open thoracotomy due to esophageal perforation.

Main Results:

• Five of six patients had successful thoracoscopic resection.
• Pathology confirmed three esophageal duplication cysts and three bronchogenic cysts.
• Average hospital stay was 5.5 days, with no mortality or recurrence; complications included aspiration pneumonia and chest tube dislodgment.

Conclusions:

• Thoracoscopic resection is a safe and effective first-line therapy for foregut duplications.
• Minimally invasive surgery improves cosmesis and reduces morbidity compared to thoracotomy.
• Good short-term outcomes with minimal morbidity and no mortality were observed.