Objective To study the operation approach and operation method for giant dumbbell neurogenic tumors of the posterior mediastinum,and summarize the experience ofthoracoscopic surgery via posterior midline approach in tumor resection.Methods The clinical data of 11 patients with posterior mediastinum dumbbell tumor,admitted to our hospital from February 2003 to May 2013,were analyzed retrospectively.Traditional posterolateral incision combined with thoracic tumor resection was performed in the 7 patients of control group;and thoracic laminectomy combined with intraspinal tumor mass resection was performed in the 4 patients of treatment group.Results The operation went smoothly.Patients in the treatment group accepted no auxiliary incision or conversion to thoracotomy,without occurrence of dysneuria and cerebrospinal fluid leakage and other serious complications.As compared with the control group,the treatment group had smaller volume of bleeding,shorter chest drainage time and hospital stays,and longer operation time.Postoperative pathology implied 8 neurofibromas and 3 schwannomas.No dysneuria or recurrence was found during the follow-up of 12-36 months.Conclusion Double-hole thoracoscopic surgery via posterior midline approach is a safe,effective,minimally invasive method in the treatment of dumbbell neurogenic tumors of the posterior mediastinum.