title: Experience with thoracoscopic resection for mediastinal mature teratoma: a retrospective analysis of 15 patients.
abstract: OBJECTIVE
  Although video-assisted thoracoscopic surgery (VATS) is widely used for the resection of a mediastinal mass, it is converted to an open resection in some patients with a mature teratoma because of dense adhesions. We reviewed cases with a mature teratoma removed by VATS and investigated the indications for that procedure for this tumour.
  
  
  METHODS
  We retrospectively investigated 15 patients with a benign mediastinal mature teratoma who underwent a thoracoscopic procedure.
  
  
  RESULTS
  The mean tumour diameter was 5.3 cm (range 3.2-8.5). The mean operative time was 188 min (78-430), and intraoperative blood loss was 138 ml (10-450). Thoracoscopic resection was completed in all except 3 patients with larger tumours, which presented the most difficult problems with dissection. Each of those 3 had severe preoperative chest pain and a tumour larger than 5.5 cm. No mortality or postoperative complications were recorded, except for postoperative chylothorax. Tumour recurrence did not develop in any patient during the mean follow-up period of 4.6 years.
  
  
  CONCLUSIONS
  For selected patients with a mediastinal teratoma, VATS may be considered standard care, as most are benign. In contrast, an open approach may be more appropriate for patients with a large tumour or preoperative symptoms.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan. yshintani@thoracic.med.osaka-u.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.forename: Soichiro
authors.initials: S
authors.lastname: Funaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakagiri
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Masato
authors.initials: M
authors.lastname: Minami
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kadota
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D002916:Chylothorax / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult