title: Management of large mediastinal masses: surgical and anesthesiological considerations.
abstract: Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor. A multidisciplinary team should decide whether neoadjuvant therapy can be beneficial. Furthermore, the anesthesiologist has to evaluate the risk of intraoperative mediastinal mass syndrome (MMS). With adequate preoperative team planning, a safe anesthesiological and surgical strategy can be accomplished.
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Wilson W L
authors.initials: WW
authors.lastname: Li
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Wim Jan P
authors.initials: WJ
authors.lastname: van Boven
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Jouke T
authors.initials: JT
authors.lastname: Annema
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Susanne
authors.initials: S
authors.lastname: Eberl
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Houke M
authors.initials: HM
authors.lastname: Klomp
authors.affiliation: 1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Bas A J M
authors.initials: BA
authors.lastname: de Mol
keywords: Mediastinal neoplasms; diagnostic techniques and procedures; preoperative and perioperative care; thoracic surgery