title: Thoracoscopic removal of neurogenic mediastinal tumors: technical aspects.
abstract: BACKGROUND
  Thoracoscopy is fast becoming the standard approach for the removal of neurogenic mediastinal tumors. However, there are risks for adjacent nervous structures (stellate ganglion, spinal cord). The aim of this study was to review the technical features of this approach.
  
  
  METHODS
  Between December 1999 and January 2003, nine patients underwent thoracoscopic resection of a mediastinal neurogenic tumor at our hospital. Five of these patients were asymptomatic with incidentally found tumor; the other four patients had compression-related syndromes. Two tumors had developed in the superior sulcus, and one had a spinal canal component (dumbell-type tumor).
  
  
  RESULTS
  Thoracoscopic dissection was possible in all cases. In one patient, resection of the tumor was performed via a combined neurosurgical and thoracoscopic approach. Seven tumors were benign nerve sheath tumors (schwannoma), and 2 were nerve cell tumors (ganglioneuroma). The postoperative course was uncomplicated in all patients.
  
  
  CONCLUSIONS
  The thoracoscopic resection of mediastinal neurogenic tumors is technically easy, except for bulky tumors of the superior sulcus and dumbbell tumors, which require a combined thoracoscopic and neurosurgical approach.
authors.affiliation: Thoracic Department, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, F-75014 , Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Arapis
authors.forename: D
authors.initials: D
authors.lastname: Gossot
authors.forename: D
authors.initials: D
authors.lastname: Debrosse
authors.forename: L
authors.initials: L
authors.lastname: Arper
authors.forename: C
authors.initials: C
authors.lastname: Mazel
authors.forename: D
authors.initials: D
authors.lastname: Grunenwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005729:Ganglioneuroma / Q000601:surgery*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods