title: Mediastinal tumor resection via open or video-assisted surgery in 31 pediatric cases: Experiences at a single institution.
abstract: BACKGROUND
  Video-assisted thoracic surgery (VATS) has been increasingly used for the diagnosis and treatment of thoracic diseases. Pediatric mediastinal tumors are often difficult to resect because of their proximity to important organs. For this reason, VATS is not established as a standard surgical approach for such tumors. We compared the efficacy and safety of mediastinal tumor resection in children using open thoracotomy (OT) and VATS.
  
  
  METHODS
  A total of 31 children underwent mediastinal tumor resection (21 by VATS and 10 by OT). These nonrandomized approaches were retrospectively compared for incidence of operative complications, morbidity, and mortality.
  
  
  RESULTS
  Tumor sizes and operation times were similar between groups. However, the VATS group required significantly fewer blood transfusions and shorter durations of thoracic drainage and hospital stays (p<0.05). Complications greater than grade 2 on the Clavien-Dindo classification occurred in four patients treated by VATS and OT. No delayed effects were noted in the survivors of either group. A patient with clear cell sarcoma of the kidney who underwent OT relapsed and died.
  
  
  CONCLUSIONS
  Although complication rates were similar between the two approaches, VATS was suggested as less invasive because of fewer blood transfusions required, and shorter thoracic drainage and hospital stay durations.
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan. Electronic address: tom-sato@ped-surg.med.tohoku.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Kazama
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Fukuzawa
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Wada
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kudo
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan. Electronic address: mnio@ped-surg.med.tohoku.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nio
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome
keywords: Mediastinal tumor; Open thoracotomy; Pediatric cancer; Video-assisted thoracic surgery