Extraction of mediastinal teratoma contents for complete thoracoscopic resection.
OBJECTIVE
Video-assisted thoracic surgery is widely applied for resection of mediastinal tumors. The mediastinal mature teratoma, however, is usually operated on via an open approach because it is generally large, making it difficult to dissect under a thoracoscopic view and remove it from the thoracic cavity. We attempted to extract intracystic material during video-assisted thoracic surgery to facilitate dissection and removal of the tumor from the thoracic cavity.


METHODS
From January 1998 to April 2013, 13 patients (9 women, 4 men; mean age 33 years, range 17-54 years) with mediastinal mature teratomas were operated on via video-assisted thoracic surgery. Intracystic contents of the tumor were aspirated before dissection or after the teratoma was dissected and placed in the retrieval pouch.


RESULTS
None of the patients required conversion to an open procedure. Operating time was 95-184 min (mean 132 min). Blood loss during the operation amounted to 10-300 mL (mean 78 mL). The tumor size ranged from 5 to 12 cm (mean 8 cm). In all cases, the tumors were confirmed pathologically to be mature cystic teratomas with no malignant components. During and after follow-up, all patients continue to do well without recurrence.


CONCLUSIONS
Extraction of intracystic contents enabled thoracoscopic resection of large mature mediastinal teratomas.
Department of General Thoracic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan h-tsubochi@omiya.jichi.ac.jp.
Hiroyoshi
H
Tsubochi
Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
Shunsuke
S
Endo
Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
Tomoyuki
T
Nakano
Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
Kentaro
K
Minegishi
Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
Kenji
K
Tetsuka
Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
Tsuyoshi
T
Hasegawa
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; 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
Cysts; mediastinal neoplasms; teratoma; thoracic surgery; video-assisted