[Thoracoscopic resection of mediastinal tumors]

Thoracoscopic surgery was performed in nine patients with benign mediastinal tumors: four neurogenic tumors, three bronchogenic cysts, a foregut cyst and a mature teratoma. Four cystic masses located in para-esophageal lesion in inferior mediastinum and four neurogenic tumors located in posterior mediastinum. A mature teratoma was adjacent to thymus in anterior mediastinum. Under general anesthesia with unilateral ventilation, the patients were turned in the lateral decubitus position and we tilt the operative table to allow gravity assistance for the displacement of the lung. A rigid telescope was inserted through a thracoport. Masses were resected using the dissecting scissors with electric cautery through two other thracoports. Thoracoscopic complete resections were performed in eight patients. In one case that was suspected of malignant tumor by preoperative evaluation, thoracoscopic tumor biopsy was performed and diagnosed as a benign neurogenic tumor during operation histopathologically. But it was resected by thoracotomy, because of its larger size (8 cm in diameter). The average operation time was 122 minutes ranging from 80 to 184 minutes in 8 patients with thoracoscopic resection. No patient has a complication resulting from the thoracoscopic surgery. The chest drainage tubes were removed on 1 or 2-POD in all cases and the average length of postoperative hospitalization was 5.3 days ranging from 4 to 9 days. The thoracoscopic resection for benign mediastinal tumors is minimally invasive and effective procedure compared with classical thoracotomy operation.