Video-assisted thoracoscopic management of anterior mediastinal masses

Abstract

The author reports his personal experience on the management of anterior mediastinal masses using video-assisted thoracoscopic surgery (VATS) at a single institution. From August 1993 to March 1995, 24 patients (14 males and 10 females ranging in age from 9 to 76 years old) with anterior mediastinal masses were diagnosed or treated by VATS. This consisted of 11 biopsies and 13 resections (11 thymectomies and 2 thymic cystectomies). Seven biopsies were performed for primary histological diagnosis (four non-Hodgkin's lymphoma, two metastatic carcinoma, one yolk sac tumor) and four biopsies were performed to detect residual tumors following chemotherapy. Complete thymectomy was accomplished in all 11 cases by examination of the thymic bed and resected specimen. We have reserved this approach for resection of benign masses only. Adequate biopsy for histological diagnosis was obtained in all 11 cases to guide further management. There was no surgical mortality or intraoperative complications. The median postoperative hospital stay for the entire group was 3 days. We conclude that VATS for resection or biopsy of an anterior mediastinal mass is technically feasible and provides an alternative to the conventional approaches in selected patients.