The diagnosis and video-assisted thoracic surgery for mediastinal bronchogenic cysts
10.7507/1007-4848.201811026
- VernacularTitle:纵隔支气管源性囊肿的诊断和电视胸腔镜手术治疗
- Author:
WANG Xun
1
,
2
;
CHEN Kezhong
1
,
2
;
LI Yun
1
,
2
;
LIU Jun
1
,
2
;
WANG Jun
1
,
2
Author Information
1. Department of Thoracic Surgery, People&rsquo
2. s Hospital, Peking University, Beijing, 100044, P.R.China
- Publication Type:Journal Article
- Keywords:
Bronchogenic cyst;
mediastinal cyst;
video-assisted thoracoscopic surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(9):848-852
- CountryChina
- Language:Chinese
-
Abstract:
Objective To emphasize the important role of video-assisted thoracoscopic surgery (VATS) in treatment of mediastinal bronchogenic cysts (MBCs). Methods We retrospectively reviewed the clinical data of 112 patients (53 males and 59 females) of mediastinal bronchogenic cysts who underwent VATS in our institution between April 2001 and Aprial 2016. Median age was 4–75 (45.6±15.0) years. All patients underwent chest CT preoperatively. The patients were divided into two groups: an anterior mediastinum group, 47 patients; a middle and posterior mediastinum group, 65 patients including 35 patients in the middle mediastinum, 30 patients in the posterior mediastinum. The average diameter was 0.5–22.0 (3.50±2.33) cm. The average CT attenuation was 0–67 (35.5±15.3) Hu on unenhanced CT. We began each operation with the VATS technique. Results The CT diagnostic accuracy for group middle and posterior mediastinum with CT value≤20 Hu was higher than others (61.5% vs. 13.1%, χ2=17.675, P<0.001). A total of 111 patients underwent VATS, only one patient converted to open thoracotomy. Cyst resection and thymectomy were conducted in 45 patients, cyst resection and extended thymectomy were conducted in 2 patients in the anterior mediastinum group. Simply cyst resection were performed in the middle and posterior mediastinum group (n=65). The average operative time was 40–360 (104.5±43.1) min. The average intraoperative blood loss was 5–600 (57.9±88.9) mL. The intraoperative complication rate was 3.6% and the incomplete resection rate was 6.3%. The main reason for these was severe adhesion between the cyst and mediastinal structure. No serious postoperative complication was found. Follow-up was done in 99 patients, and the mean follow-up time was 42 (12–191) months. There was no local recurrence. Conclusion VATS resection of MBCs is a safe and efficacious procedure, and minimally invasive and surgical resection should be performed as early as possible for MBCs.
