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Has there been a paradigm shift in mediastinal surgery from open to minimally invasive, and from magnetic resonance imaging (MRI) to positron emission tomography–computerized tomography (PET–CT) in the last decade?

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Abstract

Objective

The purpose of this study was to investigate the effects of diagnostic and surgical developments in the complete resection of the mediastinal masses.

Methods

Of 313 patients, 236 underwent therapeutic or diagnostic complete resections. We analyzed age, gender, diagnostic interventions, neoadjuvant treatment, type of surgical intervention (sternotomy, video-assisted thoracic surgery [VATS], thoracotomy), pathology, duration of hospital stay, complications, mortality, and associated diseases. Patients were divided into two groups according to the period of operation: group A included patients who were operated on between January 2002 and January 2007; group B included patients who were operated on between January 2007 and January 2012.

Results

Resection with VATS increased significantly after 2007, from 17.7 to 35 % (p = 0.03). The rate of complications increased after 2007 (p = 0.03), which was apparent in non-VATS patients (p = 0.03). The use of magnetic resonance imaging (MRI) decreased from 29 to 15.5 % (p = 0.02) and positron emission tomography (PET)–computed tomography (CT) use increased from 1.6 to 25.2 % (p < 0.001).

Conclusions

We identified a paradigm shift in mediastinal mass surgery. PET–CT became a more preferred diagnostic method and MRI became less preferred. The rate of VATS resection doubled and sternotomy decreased. Complication rates increased in non-VATS due to an increase in extended resections.

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Disclosure

Alper Toker, Suat Erus, Erkan Kaba, Serhan Tanju, and Berker Özkan have no conflicts of interest relevant to the content of this paper.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey

    Alper Toker & Berker Ozkan

  2. Artvin State Hospital, 08000, Artvin, Turkey

    Suat Erus

  3. Department of Thoracic Surgery, Medical Faculty, Bilim University, Istanbul, Turkey

    Erkan Kaba

  4. Department of Thoracic Surgery, VKF American Hospital, Istanbul, Turkey

    Serhan Tanju

Authors
  1. Alper Toker
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  2. Suat Erus
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  3. Erkan Kaba
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  4. Serhan Tanju
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  5. Berker Ozkan
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Corresponding author

Correspondence to Suat Erus.

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Toker, A., Erus, S., Kaba, E. et al. Has there been a paradigm shift in mediastinal surgery from open to minimally invasive, and from magnetic resonance imaging (MRI) to positron emission tomography–computerized tomography (PET–CT) in the last decade?. Surg Endosc 28, 861–865 (2014). https://doi.org/10.1007/s00464-013-3233-8

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  • DOI: https://doi.org/10.1007/s00464-013-3233-8

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