Mediastinal cyst involving the oesophagus: diagnosis and results of surgical treatment.
OBJECTIVE
To describe our experience with mediastinal cysts involving the oesophagus.


METHODS
Retrospective study.


METHODS
University hospital, Italy.


METHODS
11 patients who presented to our department with a mediastinal cyst from 1976-1994.


METHODS
Excision of the mass through a posterolateral thoracotomy (n = 10) or by video-assisted thoracoscopy.


METHODS
Morbidity and mortality.


RESULTS
8 patients presented with retrosternal or epigastric pain, three of whom had mild dysphagia. In the remaining 3 the tumour was asymptomatic and an incidental finding on a chest radiograph. Endoscopic ultrasonography and computed tomography (CT) allowed preoperative diagnosis of an extramucosal cyst in 5 of the 7 patients investigated by both tests. Masses were excised through a formal thoracotomy (n = 10) or by video-assisted thoracoscopy. Histological examination confirmed a benign cyst in all cases. There was no operative morbidity and nine patients are free of symptoms after a median follow-up of 2.3 years.


CONCLUSIONS
Excision, preferably by thoracoscopy, is the treatment of choice for mediastinal cysts that involve the oesophagus. Special attention should be paid to the vagal nerves, and as many as possible of the muscular layers of the oesophagus should be preserved.
Department of General Surgery and Surgical Oncology, University of Milan, Italy.
L
L
Bonavina
M
M
Pavanello
A
A
Baisi
C
C
Castoro
E
E
Ancona
A
A
Peracchia
D000293:Adolescent; D000328:Adult; D001466:Barium Sulfate; D019160:Endosonography; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008476:Mediastinal Cyst / Q000175:diagnosis* / Q000601:surgery*; D008875:Middle Aged; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed
D001466:Barium Sulfate