Advertisement

World Journal of Surgery

, Volume 42, Issue 11, pp 3638–3645 | Cite as

The Video-Assisted Thoracic Surgery for Mediastinal Bronchogenic Cysts: A Single-Center Experience

  • Xun Wang
  • Kezhong Chen
  • Yun Li
  • Fan Yang
  • Hui Zhao
  • Jun Wang
Original Scientific Report

Abstract

Objective

The aim of this study was to evaluate the outcomes of video-assisted thoracic surgery (VATS) for mediastinal bronchogenic cyst (MBC) excision and investigate the surgical indication for MBC.

Methods

We retrospectively reviewed all consecutive MBC patients who underwent surgical excision between April 2001 and June 2016. One hundred and nineteen patients were enrolled with a median age of 45.4 years and divided into two groups: anterior mediastinum group (n = 48), and middle and posterior mediastinum group (n = 71). VATS technique was initially performed for each patient. The cyst should be resected completely as far as possible. Follow-up was completed by telephone or outpatient clinic every year. The deadline of follow-up was June 2017.

Results

One hundred and eighteen patients underwent VATS, and only one patient converted to open thoracotomy. The average operative time was 103.8 ± 41.6 min (40–360 min). The average intraoperative blood loss was 56.6 ± 86.6 ml (5–600 ml). The intraoperative complication rate was 3.4%, and the incomplete excision rate was 5.9%. The multivariate logistic analysis showed that maximal diameter >5 cm was significantly associated with risk of operation time extension (OR = 3.968; 95% CI 1.179–13.355, p = 0.026) and bleeding loss increasing (OR = 12.242; 95% CI 2.420–61.933, p = 0.002). No serious postoperative complications were observed. Follow-up was performed in 102 patients, and the mean follow-up time was 45 months (12–194 months). There was no local recurrence.

Conclusions

The maximal diameter >5 cm increased risk of operation time extension and bleeding loss increasing. Early surgical excision of MBC by VATS is recommended to establish histopathological diagnosis, relieve symptoms, and prevent surgery-related complications.

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

References

  1. 1.
    Maier HC (1948) Bronchogenic cysts of the mediastinum. Ann Surg 127:476–502CrossRefGoogle Scholar
  2. 2.
    St-Georges R, Deslauriers J, Duranceau A et al (1991) Clinical spectrum of bronchogenic cysts of the mediastinum and lung in the adult. Ann Thorac Surg 52:6–13CrossRefGoogle Scholar
  3. 3.
    Ribet ME, Copin MC, Gosselin B et al (1995) Bronchogenic cysts of the mediastinum. J Thorac Cardiovasc Surg 109:1003–1010CrossRefGoogle Scholar
  4. 4.
    Guo C, Mei J, Liu C et al (2016) Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients. J Thorac Dis 8:2504–2511CrossRefGoogle Scholar
  5. 5.
    De Giacomo T, Diso D, Anile M et al (2009) Thoracoscopic resection of mediastinal bronchogenic cysts in adults. Eur J Cardiothorac Surg 36:357–359CrossRefGoogle Scholar
  6. 6.
    Weber T, Roth TC, Beshay M et al (2004) Video-assisted thoracoscopic surgery of mediastinal bronchogenic cysts in adults: a single-center experience. Ann Thorac Surg 78:987–991CrossRefGoogle Scholar
  7. 7.
    Limaiem F, Ayadi-Kaddour AH, Kilani T et al (2008) Pulmonary and mediastinal bronchogenic cysts: a clinicopathologic study of 33 cases. Lung 186:55–61CrossRefGoogle Scholar
  8. 8.
    Mcadams HP, Kirejczyk WM, Rosado-De-Christenson ML et al (2000) Bronchogenic cyst: imaging features with clinical and histopathologic correlation. Radiology 217:441–446CrossRefGoogle Scholar
  9. 9.
    Kirmani B, Sogliani F (2010) Should asymptomatic bronchogenic cysts in adults be treated conservatively or with surgery? Interact CardioVasc Thorac Surg 11:649–659CrossRefGoogle Scholar
  10. 10.
    Fievet L, D’Journo XB, Guys JM et al (2012) Bronchogenic cyst: best time for surgery. Ann Thorac Surg 94:1695–1699CrossRefGoogle Scholar
  11. 11.
    Patel SR, Meeker DP, Biscotti CV et al (1994) Presentation and management of bronchogenic cyst in the adult. Chest 106:79–85CrossRefGoogle Scholar
  12. 12.
    Maurin S, Hery G, Bourliere B et al (2013) Bronchogenic cyst: clinical course from antenatal diagnosis to postnatal thoracoscopic resection. J Minim Access Surg 9:25–28CrossRefGoogle Scholar
  13. 13.
    Lewis RJ, Caccavale RJ, Sisler GE et al (1992) Imaged thoracoscopic surgery: a new thoracic technique for resection of mediastinal cysts. Ann Thorac Surg 53:318–320CrossRefGoogle Scholar
  14. 14.
    Tölg C, Abelin K, Laudenbach V et al (2005) Open versus thoracoscopic surgical management of bronchogenic cysts. Surg Endosc 19:77–80CrossRefGoogle Scholar
  15. 15.
    Jung HS, Dong KK, Lee GD et al (2014) Video-assisted thoracic surgery for bronchogenic cysts: is this the surgical approach of choice? Interact CardioVasc Thorac Surg 19:824–829CrossRefGoogle Scholar
  16. 16.
    Martinod E, Pons F, Azorin J et al (2000) Thoracoscopic excision of mediastinal bronchogenic cysts: results in 20 cases. Ann Thorac Surg 69:1525–1528CrossRefGoogle Scholar
  17. 17.
    Read CA, Moront M, Carangelo R et al (1991) Recurrent bronchogenic cyst: an argument for complete surgical excision. Arch Surg 126:1306–1308CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Xun Wang
    • 1
  • Kezhong Chen
    • 1
  • Yun Li
    • 1
  • Fan Yang
    • 1
  • Hui Zhao
    • 1
  • Jun Wang
    • 1
  1. 1.Department of Thoracic SurgeryPeking University People’s HospitalBeijingPeople’s Republic of China

Personalised recommendations