title: The surgical management and outcome of congenital mediastinal malformations.
abstract: We reviewed our institutional experience with congenital mediastinal masses and compared the postnatal management and outcome of patients with or without prenatal diagnosis. Between January 1997 and August 2011, 24 patients underwent surgical procedures for congenital mediastinal mass. For eight patients, the mass was detected by prenatal ultrasonography at 27 weeks of gestation (range 22-35). Postnatal management consisted in open surgery for seven patients at a mean age of 9 months (range 1 day-20 months) and sclerotherapy for one lymphangioma at 5 months of life. Sixteen patients had postnatal diagnosis at 137 months (±194) of median age. Eight bronchogenic cysts, seven bronchopulmonary foregut malformations, five teratomas, three lymphangiomas and one haemangioma were operated on. The median age at resection was 28 months (1 day-15 years). There were four emergency procedures and no surgical mortality. The median follow-up was 45 months (3-144). The duration of mechanical ventilation and hospital stay was, respectively, 4.6 h and 7.5 days for antenatal patients and 24.3 h and 14.3 days for postnatal diagnosed patients. Prenatal diagnosis allows early management of congenital mediastinal malformations. Early resection can be performed prior to the occurrence of symptoms ∼1 year of life and is associated with an excellent outcome and less morbidity.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, Toulouse Cedex 9, France. q.ballouhey@gmail.com
authors.forename: Quentin
authors.initials: Q
authors.lastname: Ballouhey
authors.forename: Philippe
authors.initials: P
authors.lastname: Galinier
authors.forename: Olivier
authors.initials: O
authors.lastname: Abbo
authors.forename: Guillaume
authors.initials: G
authors.lastname: Andrieu
authors.forename: Christiane
authors.initials: C
authors.lastname: Baunin
authors.forename: Agnès
authors.initials: A
authors.lastname: Sartor
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Rittié
authors.forename: Bertrand
authors.initials: B
authors.lastname: Léobon
mesh_terms: D000293:Adolescent; D001994:Bronchogenic Cyst / Q000601:surgery; D001998:Bronchopulmonary Sequestration / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery; D008482:Mediastinum / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D011237:Predictive Value of Tests; D012121:Respiration, Artificial; D015619:Respiratory System Abnormalities / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal