title: Descending necrotizing mediastinitis: minimally invasive thoracic surgical treatment.
abstract: OBJECTIVE
  To report a case series of patients with descending necrotizing mediastinitis (DNM) who were treated with minimally invasive thoracic surgery.
  
  
  METHODS
  We report three cases of male patients with DNM who underwent mediastinal debridement by video-assisted thoracic surgery at the Hospital São Paulo, located in the city of São Paulo, Brazil, from admission to the final outcome.
  
  
  RESULTS
  The postoperative evolution was favorable in all three cases. The mean length of hospital stay was 16.7 days.
  
  
  CONCLUSIONS
  We conclude that video-assisted thoracoscopy is an effective technique for mediastinal drainage in the treatment of DNM, with the benefits common to minimally invasive surgery: less postoperative pain, lower production of inflammatory factors, earlier return to activities of daily living, and better aesthetic results.
authors.affiliation: Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil. cromwellmelo@hotmail.com
authors.forename: Cromwell Barbosa de Carvalho
authors.initials: CB
authors.lastname: Melo
authors.forename: Petrúcio Abrantes
authors.initials: PA
authors.lastname: Sarmento
authors.forename: Carlos Jogi
authors.initials: CJ
authors.lastname: Imaeda
authors.forename: Danilo Félix
authors.initials: DF
authors.lastname: Daud
authors.forename: Fábio Nishida
authors.initials: FN
authors.lastname: Hasimoto
authors.forename: Luiz Eduardo Villaça
authors.initials: LE
authors.lastname: Leão
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000473:pathology* / Q000601:surgery*; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*