Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients

Abstract

The patient demographic characteristics, intraoperative findings, postoperative outcomes and follow-up information were reviewed and analyzed. Results: A total of 99 patients underwent cystectomy were enrolled for the present study. Of those patients, 65 underwent VATS cystectomy (VATS group) and 34 underwent PLT cystectomy (PLT group) during the same period. The VATS group had shorter operative time than the PLT group (108.77±47.81 vs. 144.62±55.16, P=0.001), less intraoperative blood loss (median 20 vs. 100 mL, P<0.001), and less pleural drainage of the first three days after surgery (median 240 vs. 400 mL, P=0.002). In addition, the length of postoperative hospital stay and duration of chest drainage for the VATS group was also shorter than those of the PLT group (4.94±2.01 vs. 8.64±5.52 days, P=0.001; 2.52±1.29 vs. 3.71±1.55 days, P<0.001, respectively). No statistical significance was revealed among the two groups with regard to the maximum diameter of the cysts, pleural atresia, incomplete resection, surgery-related complications, duration of intensive care unit stay, and postoperative complications. Conclusions: Both VATS and PLT are reliable approaches for the surgical resection of MBCs. The VATS approach is superior to PLT with shorter operative time, shorter duration of chest drainage, shorter postoperative hospital stay, less intraoperative blood loss, and less pleural drainage of the first three days after surgery. We conclude that VATS should be the preferred approach for the treatment of MBCs. represent 18% of all primary mediastinal malformations, the exact incidence of Mediastinal bronchogenic cysts (MBCs) is unknown because most patients are asymptomatic (1,4,5). However, more and more patients were detected because of the advanced diagnostic equipment and the increasing application of routine medical examinations in recent years.For adult patients with MBC, surgical resection is generally performed through posterolateral thoracotomy (PLT). With the recent advances in endoscopic instruments and operative techniques, video-assisted thoracic surgery (VATS) resection of MBC has been used with increasing frequency since it was first performed by Mouroux and associates in 1991 (6); it may become a potentially new surgical choice for the treatment of MBCs. However, limited studies have been published to compare the results of VATS versus PLT in adult patients with MBC, thus, uncertainty remains as to whether VATS can be an alternative to PLT for the treatment of MBCs. Thus, we retrospectively reviewed the data of patients with MBCs to reveal whether VATS was superior to PLT or not when concerning the effectiveness and safety in treating MBCs. Methods Data collectionPatients with MBCs who underwent surgical resection between August 2005 and December 2015 were identified from the electronic database of the Department of Thoracic Surgery, West China Hospital, Sichuan University. The clinical history of these patients was reviewed including the following items: patient demographic characteristics [age,...

Complete thoracoscopic excision of an infected bronchogenic cyst due to mediastinitis

“…Because the VATS technique result in less damage to patients, even complicated bronchogenic cysts can be safely managed using the VATS technique (3,6). To the best of our knowledge, this is the first case of infected bronchogenic cyst caused by mediastinitis and we describe how a surgical approach using VATS should be considered for treatment, even among patients with complicated bronchogenic cysts.…”

“…Because surgical excision can be hazardous and incomplete due to dense adhesion to surrounding vital organs after severe inflammation, drainage of complicated bronchogenic acute-phase cysts using bronchoscopy, mediastinoscopy, or percutaneous CT-guided methods has been performed to decompress them and relieve inflammation (2,5). However, drainage is not considered a definitive treatment modality for complicated cysts because of recurrence or incomplete removal (6).…”

Clinical characteristics and management of primary mediastinal cysts: A single‐center experience

“…Since that time, VATS has been increasingly adopted to treat various mediastinal cysts. 2,[12][13][14][15] Guo and colleagues 16 compared VATS versus traditional thoracotomy in patients undergoing surgical resection of PMCs and confirmed that VATS could reduce the operative duration and intraoperative blood loss without increasing the risks of incomplete resection and intraoperative and postoperative complications. In our series, VATS was initially performed for all patients.…”

Comparison of video-assisted thoracoscopic surgery and thoracotomy in the treatment of mediastinal cysts

“…[19] Moreover, as with our study, it was shown that the duration of operation and hospitalization were shorter with VATS. [19,20] The mean duration of VATSs was 87.4±17.6 min, while it was 123.6±24.7 min with surgeries performed with thoracotomy. Furthermore, postoperative duration of hospital stay after thoracotomies was mean 8.2 days, while it was 4.3 days after VATSs.…”