title: Surgical approach to posterior mediastinal lesions and long-term outcomes.
abstract: Background Posterior mediastinal lesions are classified as solid lesions and cysts. The treatment for both types is surgery. We evaluated the surgical outcomes and recurrence rates after video-assisted thoracic surgery and thoracotomy for posterior mediastinal lesions. Methods Data of 66 resections for posterior mediastinal masses between 2000 and 2014 were reviewed retrospectively. Twenty-two patients were treated by video-assisted thoracic surgery (group V) and 44 underwent thoracotomy (group T); 29 (43.9%) were female and 37 (56.1%) were male, the mean age was 45.9 ± 14.7 years. Results Bronchogenic cyst was the most common cystic lesion (10/12, 83.3%), and benign schwannoma was the most common solid lesion (32/54, 59.2%). The mean diameter of solid lesions was 5.19 ± 2.4 cm (group V 3.98 ± 1.8 vs. group T 5.78 ± 2.5 cm, p = 0.006). The tumor diameter was 4.06 ± 1.9 cm in asymptomatic patients and 6.93 ± 2.2 cm ( p < 0.001) in symptomatic patients. In group V, hospital stay and duration of drainage were significantly shorter than in group T ( p = 0.02, p = 0.01). Local recurrence was detected in 4 (6.1%) patients. Cystic lesions had a higher recurrence rate than solid lesions ( p = 0.01). There was no significant difference in recurrence rates in groups V and T ( p = 0.59). Conclusion Video-assisted thoracic surgery is a safe method for surgical treatment of posterior mediastinal lesions, with a shorter drainage time and postoperative hospitalization and similar recurrence rates. More recurrences are seen in patients with cystic lesions.
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Celalettin I
authors.initials: CI
authors.lastname: Kocaturk
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Celal B
authors.initials: CB
authors.lastname: Sezen
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Aker
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cem E
authors.initials: CE
authors.lastname: Kalafat
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Bilen
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali C
authors.initials: AC
authors.lastname: Kutluk
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Karapinar
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sertan
authors.initials: S
authors.lastname: Erdogan
authors.affiliation: Thoracic Surgery Department, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozkan
authors.initials: O
authors.lastname: Saydam
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008476:Mediastinal Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Mediastinal Neoplasms; Mediastinal cyst; Thoracic surgery; Thoracotomy; Treatment outcome; video-assisted