Šafránek J., Špidlen V., Vodička J.: Mediastinal Cysts, Surgical Management

Authors: J. Šafránek;  V. Špidlen;  J. Vodička
Authors‘ workplace: Chirurgická klinika FN Plzeň, přednosta: prof. MUDr. V. Třeška, DrSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 5, s. 277-280.
Category: Monothematic special - Original


Mediastinal cysts are common lesions, affecting children, as well as adults. They account for 20–30 % pathological mediastinal masses. The treatment is surgical, including extirpation, respectively enucleation of the cyst.

Aim of the study:
Assessment of the author’s patient group and overview of current literature data.

Material and Methods:
Retrospective analysis of a group of 11 patients (9 female and2 male subjects, the mean age was 47.6 years) indicated for scheduled procedures for mediastinal cysts from 2006 to 2010.

Histological examination confirmed pericardial cysts in 7 subjects (63.6%), brochogenic cysts in 3 (27.3%) subjects and a thymic cyst in one subject (9.1%). The commonest location was anterior mediastinum – 7 subjects (63.6%), whereas upper mediastinum was the cyst site in 3 (27.3%) subjects and posterior mediastinum in 1 (9.1%) subject. Thoracotomy was indicated in 3 subjects, one subject was indicated for lung resection for carcinoma using thoracotomy and the pericardial cyst was a secondary known diagnosis, one patient was operated using sternotomy. 6 patients were indicated for videothoracoscopic (VTS) procedures and a decision to convert to thoracotomy was taken in 2 of these subjects. The patients were discharged from hospital 4–12 days after thoracotomy (the mean of 6.67 days), 3–4 days after VTS (the mean of 3.25 days), while the patient undergoing sternotomy was discharged on the postoperative Day 8. The mean size of the cysts removed using thoracotomy was 78 x 55 mm and the mean size of the cysts removed using VTS was 50 x 29 mm.

The surgical technique for expected mediastinal cysts should be selected based on the cysts location, rather than on their size. The main objective is to indicate each mediastinal cyst for VTS (shorter duration of hospitalization) and eventual conversion to thoracotomy does not cause any delays or complications. Also asymptomatic cysts should be indicated for surgery.

Key words:
mediastinal cysts – videothoracoscopy – thoracotomy


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