Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Allen MS, Trastek VF, Pairolero PC. Benign Germ Cell Tumors of the Mediastinum. In: Shields TW, Joseph L, Reed CE, Fein RH, editors. General Thoracic Surgery: Lippincott Williams & Wilkins; 2009. p. 2266–510.
    1. Lewis B, Hurt R, Payne W, Farrow G, Knapp R, Muhm J. Benign teratomas of the mediastinum. J Thorac Cardiovasc Surg. 1983;86(5):727–731. doi: 10.1016/S0022-5223(19)39090-7. - DOI - PubMed
    1. Hwang SK, Park SI, Kim YH, Kim HR, Choi SH, Kim DK. Clinical results of surgical resection of mediastinal teratoma: efficacy of video-assisted thoracic surgery. Surg Endosc. 2016;30(9):4065–4068. doi: 10.1007/s00464-015-4721-9. - DOI - PubMed
    1. Sato T, Kazama T, Fukuzawa T, et al. Mediastinal tumor resection via open or video-assisted surgery in 31 pediatric cases: experiences at a single institution. J Pediatr Surg. 2016;51(4):530–533. doi: 10.1016/j.jpedsurg.2015.09.021. - DOI - PubMed
    1. Bousamra M, II, Haasler GB, Patterson GA, Roper CL. A comparative study of thoracoscopic vs open removal of benign neurogenic mediastinal tumors. Chest. 1996;109(6):1461–1465. doi: 10.1378/chest.109.6.1461. - DOI - PubMed