Document Detail


[Indication of Video-assisted Thoracic Surgery for Mediastinal Mass Lesions].
MedLine Citation:
PMID:  23023535     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background:Most of mediastinal tumors are benign cysts and neoplasms. Resection is indicated for cystic lesions because of possibility of malignancy, compression symptom and possible rupture in future. However careful observation might be appropriate for asymptomatic tumors without risk of malignancy. Although video-assisted thoracoscopic surgery (VATS) is increasingly performed, its indication is still controversial. Patients and Results:Among 37 mediastinal cystic lesions with confirmed pathological diagnosis, 17 were neoplasms. All of 20 non-neoplastic lesions have cyst wall thinner than 5 mm. Five cases( 29%) of neoplastic lesions have cyst wall thinner than 5 mm. Three of them underwent preoperative fluorodeoxyglucose-positron emission tomography( FDG-PET) or PET-computed tomography( CT). All 3 neoplastic lesions with thin wall showed accumulation of FDG. None of non-neoplastic cyst had FDG accumulation. Ninety-seven patients underwent surgical resection for mediastinal tumors. Out of 51 VATS, 2 were converted to open thoracotomy. One patient with thymoma had ipsilateral pleural recurrence after VATS. Tumor sizes of those 3 patients were larger than 7 cm. Conclusions:Cystic mediastinal tumor with wall thickness less than 5 mm and no FDG accumulation might be observed without resection because it is very unlikely to be a neoplasm. Mediastinal tumor larger than 7 cm might not be suitable for VATS.
Authors:
Yasuhiro Hida; Jun Muto; Kichizo Kaga; Tatsuya Kato; Keidai Ishikawa; Reiko Nakada-Kubota; Kazuto Ohtaka; Yoshiro Matsui
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Kyobu geka. The Japanese journal of thoracic surgery     Volume:  65     ISSN:  0021-5252     ISO Abbreviation:  Kyobu Geka     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413533     Medline TA:  Kyobu Geka     Country:  Japan    
Other Details:
Languages:  jpn     Pagination:  934-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, Hokkaido University, Sapporo, Japan.
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