Original Thoracic	Thorac cardiovasc Surg 2008; 56: 278-282 DOI: 10.1055/s-2008-1038630
© Georg Thieme Verlag KG Stuttgart · New York
Videothoracoscopic Excision of Mediastinal Tumors and Cysts Using the Harmonic Scalpel
L. Lang-Lazdunski1, J. Pilling1
1 Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom

Abstract

Objective: The aim of this study was to evaluate the safety and reliability of the Harmonic Scalpel for performing VATS excisions of mediastinal tumors and cysts. Methods: We have prospectively studied 19 cases presenting with a mediastinal tumor or cyst operated on consecutively since January 2003. Results: We performed 10 left-sided and 9 right-sided VATS procedures; the mean age at operation was 50 ± 15 years. Two masses were in the anterior mediastinum, 5 in the middle mediastinum and 12 in the posterior mediastinum. One patient required conversion to a minithoracotomy for bleeding. The maximum tumor diameter was 38 ± 14 mm and the maximum cyst dimension was 55 ± 20 mm. The mean operating time was 66 ± 28 min. Three patients experienced minor complications. The postoperative hospital stay was 3.5 ± 1.7 days, and we had no mortality. Histopathology revealed 1 esophageal leiomyosarcoma, 1 Langerhans cell histiocytosis X, 1 hamartoma, 5 schwannomas, 1 neurofibroma, 1 malignant peripheral nerve sheath tumor, 1 reactive lymphadenopathy, 1 tuberculous lymphadenopathy, 1 cystic hygroma, 2 bronchogenic cysts, 2 foregut cysts, 1 thymic cyst, and 1 pleuropericardial cyst. There has been no recurrence of tumor or cyst on follow-up. Conclusions: Videothoracoscopic excision of mediastinal tumors and cysts can be safely performed using the Harmonic Scalpel with a low morbidity and mortality.

Key words

videothoracoscopy - mediastinum - tumor - cyst