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. 2020 Feb 12;15(1):35.
doi: 10.1186/s13019-020-1076-7.

Thoracoscopic surgery approach to mediastinal mature teratomas: a single-center experience

Lu Huu Pham  1   2 , Diep Ke Trinh  3 , Anh Viet Nguyen  1 , Lanh Sy Nguyen  4 , Dung Thanh Le  5 , Dinh-Hoa Nguyen  6 , Hung Quoc Doan  1   2 , Uoc Huu Nguyen  1   2
Affiliations

Thoracoscopic surgery approach to mediastinal mature teratomas: a single-center experience

Lu Huu Pham et al. J Cardiothorac Surg. .

Abstract

Background: Mediastinal mature teratomas are rare tumors with diverse surgical approaches. The aim of this study is to review our experience of thoracoscopic surgery management in patients with teratomas.

Methods: We retrospectively reviewed 28 consecutive patients with mediastinal mature teratomas who underwent thoracoscopic surgery at Viet Duc University Hospital from January 2008 to August2018. Patients were divided into 2 groups with 2 types of thoracoscopic surgery, closed thoracoscopic surgery (CTS) group and video-assisted thoracoscopic surgery (VATS) group. The selection of sugical approach was based on sizes, locations and characteristics of tumors. Post-operative outcomes were assessed and compared between these 2 groups.

Results: There were 14 female and 14 male patients with a median age of 41.2 ± 13.8 years. A total of 22 teratomas were located on the right side of the chest cavity and 6 on the left side. We performed CTS in 21 patients (75%) and VATS in 7 patients (25%) for tumor resection. There were 3 cases (10.7%) required conversion to minithoracotomy (5 cm in incision length). Skin appendages accounted for the highest rate (96.4%) in pathology. There was no record of mortality or tumor recurrence detected by computerized tomography.

Conclusion: A thoracoscopic surgery for a mediastinal mature teratoma was a feasible choice. Challenging factors such as large tumors, intraoperative bleeding and strong tumor cell adhesion were considered handling by conversion to mini-thoracotomy that could ensure safety procedures and complete removal of tumors. Extraction of tumor contents might be performed for patients with large mature cystic teratomas to facilitate thoracoscopic surgery.

Keywords: Mediastinal mature teratomas; Thoracoscopic surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Mediastinal mature teratomas on CT-scanner. a Adhesion lesion with surrounding organs [arrow] – VATS conversion mini-thoracotomy and b clear boundary with surrounding organs [arrow]
Fig. 2
Fig. 2
In-operative lesion with dissection by CTS (use the harmonic scapel)
See this image and copyright information in PMC

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