Thorac cardiovasc Surg
DOI: 10.1055/s-0036-1586156
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Surgical Approaches to Non-thyrogenic and Non-thymic Mediastinal Tumors of the Thoracic Inlet

Yu Liu1, Tao Lu1, Hong Fan1, Songtao Xu1, Jianyong Ding1, Zongwu Lin1, Qun Wang1
  • 1Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, China
Further Information

Publication History

24 May 2016

09 June 2016

Publication Date:
05 August 2016 (eFirst)

Abstract

Background Non-thyrogenic and non-thymic mediastinal tumors of the thoracic inlet are in close proximity to several important vessels and nerves. The narrow confines of the thoracic inlet make complete excision of these tumors difficult, and selecting the appropriate surgical approach is important to successful resection.

Methods Records from 57 patients who presented to our department with non-thyrogenic and non-thymogenic tumors of the thoracic inlet from November 2004 to November 2015 were reviewed. All but one of the patients received surgical treatment. Thirty-two tumors were excised via video-assisted thoracic surgery (VATS). Other approaches included thoracotomy, supraclavicular incision, supraclavicular incision plus thoracotomy/VATS, and a posterior midline approach with semi-laminectomy combined with VATS.

Results Tumors were resected completely in 54 cases and partially in one. One procedure (VATS) was aborted. There were no surgical mortalities, but there were some postoperative complications. The majority of the tumors were benign neurogenic tumors.

Conclusions Most tumors of the thoracic inlet are benign and can be removed via VATS. Thoracotomy is the appropriate approach for large tumors, particularly in cases where the first to second rib cannot be visualized. A supraclavicular approach is recommended for resection of tumors arising from the brachial plexus, and a supraclavicular approach combined with VATS or thoracotomy may be useful for larger masses. A posterior midline approach with semi-laminectomy combined with VATS is appropriate for dumbbell-shaped tumors.