GULHANE MEDICAL JOURNAL 2019 , Vol 61 , Issue 3
A retrospective analysis of surgical approach to the mediastinal lesions
Ersin Sapmaz1,Merve Şengül İnan1,Hakan Işık1,Okan Karataş2,Kuthan Kavaklı1,Onur Genç 1
1University of Health Sciences, Gulhane Training and Research Hospital, Department of Thoracic Surgery, Ankara, Turkey
2Sinop Atatürk State Hospital, Department of Thoracic Surgery, Sinop, Turkey
DOI : 10.26657/gulhane.00068 Aims: The mediastinal masses represent a wide variety of diseases. Most of the masses are detected incidentally. The patient"s symptoms usually occur as a result of compression or invasion of the surrounding tissue. In spite of difficult anatomic access for tumors of mediastinum, surgical resection remains the best diagnostic and therapeutic approach. In this study, we aimed to show the surgical modalities according to the mediastinal location and the changes in the surgical methods applied to the lesions with similar pathologies in time.

Methods: We retrospectively reviewed the medical records of patients between 2003 and 2018 who underwent surgical intervention for mediastinal masses. A total of 241 patients included to the study. The age, sex, surgical methods, pathology results, localization of the masses, pathology results, surgical methods according to the localizations and changing of surgical methods applied to patients with the same regions and the same pathologies were examined in time.

Results: Of the 241 patients, 69 (28.6%) were female and 172 (71.4%) were male. The lesions were located in the anterior mediastinum in 164 (68.1%) patients, in the middle mediastinum in 40 (16.6%) and in the posterior mediastinum in 37 (15.3%) of the patients. In the last 5 years, 69 (67%) of 103 patients had robotic surgery and 10 (9.7%) had sternotomy.

Conclusions: Preoperative evaluation of mediastinal lesions should be performed carefully. The advantages of minimally invasive procedures should always be considered for selected patients. Minimally invasive procedures can be used safely in the complete resection of selected mediastinal masses. Keywords : Robotic surgery, mediastinal tumor, sternotomy, thoracotomy, VATS, RATS