Diagnosis and treatment of mediastinal tumors by thoracoscopy.
OBJECTIVE
Thoracoscopic management of mediastinal tumors is still subject to analysis. Seventy-three patients underwent thoracoscopy for treatment of mediastinal masses and were analyzed retrospectively in order to evaluate the effectiveness and complications of the procedure.


METHODS
Between 1983 and 1999, 21 conventional thoracoscopies and 52 video-assisted thoracic surgeries were performed (33 for diagnostic purposes and 40 for therapy). Patient ages ranged from 2 to 81 years (mean, 43.8 years) with a slight predominance of girls and women over men and boys (41 vs 32, respectively). All patients underwent general anesthesia using simple intubation (22 patients) or double-lumen intubation (51 patients).


RESULTS
The histologic type of tumors was obtained in all patients. For therapeutic purposes, a change of procedure to thoracotomy was necessary in nine patients. The reasons for this change were tumor size, tumor invasion of nearby structures, difficulties in continuing the dissection, the performance of an upper lobectomy, and suturing the iatrogenic lesion of the diaphragm. Four patients died during the first 30 postoperative days as a consequence of their primary pathology.


CONCLUSIONS
Thoracoscopy was confirmed as an effective diagnostic and therapeutic alternative for the treatment of mediastinal disorders.
Cirino
L M
LM
Division of Thoracic Surgery, Hospital das Clínicas, the University of São Paulo Medical School, Brazil.
Milanez de Campos
J R
JR
Fernandez
A
A
Samano
M N
MN
Fernandez
P P
PP
Filomeno
L T
LT
Jatene
F B
FB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008476:Mediastinal Cyst / Q000175:diagnosis / Q000601:surgery; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013906:Thoracoscopy; D016896:Treatment Outcome; D020535:Video-Assisted Surgery