Neurogenic tumors located in the posterior mediastinum, generally require surgery which be confronted with greater risk,therefore, to design the best surgical approach and surgical methods is essential. A 67-year-old female patient had pharyngeal foreign body sensation and dysphagia. Thyroid ultrasound showed the right thyroid had a little nodule, and the left thyroid had a hypoechoic lumps. Neck enhanced CT showd mediastinal mass, esophageal tumor origin or stromal tumor? We used the jugular approach to resect the tumor which eventually diagnosed as schwannoma. The meditational benign tumor with an envelope easy to peel can employ the jugular approach to resect it completely.
Aged ; Female ; Humans ; Jugular Veins ; Mediastinal Neoplasms ; surgery ; Mediastinum ; pathology ; Neck ; surgery ; Neurilemmoma ; surgery

Video-assisted thoracoscopic surgery has gained a broad acceptance for various thoracic lesions because it is the minimally invasive surgery with little tissue trauma, less pain, improved cosmetic results and short recovery time. However, there are some limitations for this method, such as restricted visual sensory information to a two-dimensional image and limited maneuverability of the tips of the instruments. To overcome these limitations, advanced technology has been introduced and the da Vinci(TM) Surgical System (Intuitive Surgical Inc, Mountain View, CA, USA) became available in 2001. In Korea, the da Vinci(TM) Surgical System was introduced in Severance hospital (Yonsei University College of Medicine) in May 2005, and approved by KFDA in July 2005. Herein, we report the first experience of robot-assisted thoracic surgery with the da Vinci(TM) Surgical System in extirpation of a large teratoma in anterior mediastinum.
Korea* ; Mediastinal Neoplasms ; Mediastinum ; Robotics ; Surgical Procedures, Minimally Invasive ; Teratoma ; Thoracic Surgery* ; Thoracic Surgery, Video-Assisted

Four thoracic evacuation techniques for pneumothorax elimination after diaphragmatic defect closure were compared in 40 canine cadavers. After creating a defect in the left side of the diaphragm, thoracic drainage was performed by thoracostomy tube insertion through the defect and a small (DD-SP) or large (DD-LP) puncture created in the caudal mediastinum, or through both the diaphragmatic defect and intact contralateral diaphragm with a small (DI-SP) or large (DI-LP) puncture in made in the caudal mediastinum. Differences in intrapleural pressure (IPP) between the right and left hemithoraxes after air evacuation along with differences in IPP before making a defect and after air evacuation in each hemithorax were calculated. A difference (p < or = 0.0011) in IPP between the left and right hemithoraxes after air evacuation as well as before making a defect and after air evacuation in the right hemithorax was detected for the DD-SP group. No significant differences (p > or = 0.0835) were observed for the DI-LP, DD-LP, or DI-SP groups. Creation of a large mediastinal puncture or thoracic evacuation through both a diaphragmatic defect and intact contralateral diaphragm can facilitate proper pneumothorax elimination bilaterally after diaphragmatic defect closure in dogs with a small puncture in the caudal mediastinum.
Animals ; Cadaver ; Chest Tubes/veterinary ; Diaphragm/*surgery ; Dog Diseases/*surgery ; Dogs ; Mediastinum/*surgery ; Pneumothorax/surgery/*veterinary ; Thoracostomy/instrumentation/*methods/veterinary

Aged ; Calcinosis ; diagnosis ; pathology ; surgery ; Female ; Humans ; Mediastinal Neoplasms ; diagnosis ; pathology ; surgery ; Mediastinum ; pathology ; surgery ; Thoracic Surgery, Video-Assisted

OBJECTIVE: To explore the feasibility of cervical approach for goiter in posterior mediastinum. METHOD: According to the mechanism that goiter filed into posterior mediastinum and the dissection of thyroid gland and mediastinum, we designed the following surgery principles (1) From top to bottom. (2) Find out recurrent nerve at the place where it enters larynx, then dissect recurrent nerve as long as possible and protect it carefully, meanwhile, search thyroid vessels along recurrent nerve. (3) To avoid and uncontrollable serious hemorrhage in the operation, all normal and aberrant blood vessels must be ligated cautiously, and avoid pulling great vessels in the thoracic part. (4) Separating tumor of hemorrhage under surgical capsule. Bluntly, it can avoid damage important structure in most occasions. (5) If the tumor of hemorrhage was difficult to be separated from the surrounding structure, ask thoracic surgeon for cooperation. RESULT: Two operations case were operated under the above guideline successfully, and the operations were performed with satisfactory effect, minimal invasion, rapid recovery and low medical cost. CONCLUSION Cervical approach for goiter in mediastinum posterior is an ideal method of surgery, but it has following operative indication. (1) imaging date indicate that tumor of posterior septum is not connected to the surrounding structure. (2) It is not accompanied with superior vena cava syndrome. (3) The size of large thyroid tumor of posterior septum could be decreased by taking out the center part of tumor, and it is suitable for liquidized center tissue especially, then take out the tumor from neck. If it is hard to be taken out, you can ask thoracic surgeon for help.
Contraindications ; Female ; Goiter ; surgery ; Humans ; Mediastinum ; surgery ; Middle Aged ; Neck ; surgery ; Orthopedic Procedures ; methods ; Thyroid Neoplasms ; surgery

Schwannoma represents approximately 40% of neurogenic tumors arising in the mediastinum, and develops along the sympathetic or parasympathetic chain, intercostals nerve, and spinal ganglia. It is usually asymptomatic, and is confronted accidentally but can produce chest pain, cough and dyspnea. However, dyspnea with pleural effusion is rare in patients with benign schwannoma. We encountered two cases of benign schwannoma with pleural effusion. Both cases had similar initial symptoms and the characteristics of a mass but the characteristics of pleural effusion analysis were different. The benign schwannoma was confirmed in two cases using VATS (video-assisted tharawswpic surgery).
Chest Pain ; Cough ; Dyspnea ; Ganglia, Spinal ; Humans ; Mediastinum ; Neurilemmoma* ; Pleural Effusion* ; Thoracic Surgery, Video-Assisted

Myelolipoma in the mediastinum is an extremely rare entity. In this report, we present the case of a 79-year-old asymptomatic man who had three bilateral paravertebral mediastinal tumors. The three tumors were resected simultaneously using bilateral three-port video-assisted thoracoscopic surgery (VATS). There has been no evidence of recurrence within four years after the operation. Multiple bilateral mediastinal myelolipomas are extremely rare. There are no reports in the English literature of multiple bilateral thoracic myelolipomas that were resected simultaneously using bilateral VATS. We also present characteristic features of myelolipomas, which are helpful for diagnosis.
Aged ; Diagnosis ; Mediastinal Neoplasms ; Mediastinum ; Myelolipoma* ; Recurrence ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy

An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.
Aneurysm ; Azygos Vein ; Mediastinum ; Pulmonary Embolism ; Rupture ; Thoracic Surgery, Video-Assisted

An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.
Aneurysm ; Azygos Vein ; Mediastinum ; Pulmonary Embolism ; Rupture ; Thoracic Surgery, Video-Assisted

Thymic cysts are uncommon benign lesions in the anterior mediastinum. We here describe a 55-year-old male with spontaneous thymic cyst hemorrhage manifesting as a rapidly enlarging mediastinal mass that was resected completely with video-assisted thoracoscopic surgery. To the best of our knowledge, this is the first report of a spontaneous thymic cyst hemorrhage in Korea. In cases of rapidly enlarging mediastinal masses, spontaneous thymic cyst hemorrhage should be considered as a differential diagnosis.
Diagnosis, Differential ; Hemorrhage* ; Humans ; Korea ; Male ; Mediastinal Cyst* ; Mediastinum ; Middle Aged ; Thoracic Surgery, Video-Assisted