VATS is now used by many thoracic surgeons and in various anatomic locations such as lung parenchyme, pleura and mediastinum, etc. VATS of mediastinal masses has special characteristics compared to that of other diseases. Those are no positional
changes
of the mass during collapse of the lung and close proximity of the mass to major vascular structures, nerves and other vital organs.
From 1992. July to 1993. August, 10 mediastinal masses were treated with video assisted thoracoscopy. There were five males and five females, ages ranged from 11 years to 65 years with average 37.7*17.7 years old. Of the 10 patients, 4 were
bronchogenic
cysts, 2 were teratoma, and the others were thymoma, neurilemmoma, pericardial cyst, and thymic cyst. Needle aspiration was done in large cysts and the working thoracotomy(or utility thoracotomy) was done in large solid masses for the purpose of
easy
dissection, easy handling and easy delivery of the mass.
The average operation time were 155.6*6.8 minutes and the duration of air leakage were 1*2.2 days. The duration of the chest tube drainage were 3.3*2.6 days. The lengths of postoperative hospitalization were 5.1*2.7 days which were shorter than
those of
12 mediastinal masses treated with conventional thoracotomy during the same periods(p<0.05). There was 1 patient converted to thoracotomy because of a bleeding at innominate vein.
3 postoperative complications were occured. Those were persistent air leakage for 7 days, diaphragmatic palsy and hoarseness which were recovered within 1 month.
We conclude that mediastinal mass can be excised with video assisted thoracoscopy and the posthospitalization is reduced. But careful attention is required for avoiding injury to major vascular structures, nerves, and other vital organs. (Korean
J
Thoracic Cardiovas Surg 1994; 27:226-9)
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