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
. 2021 Jan;37(1):44-52.
doi: 10.1007/s12055-020-01023-x. Epub 2020 Sep 2.

Long-term outcome in mediastinal malignancies: video-assisted thoracoscopic versus open surgery

Huynh Quang Khanh  1 , Nguyen Van Khoi  1   2 , Nguyen Lam Vuong  2   3
Affiliations

Long-term outcome in mediastinal malignancies: video-assisted thoracoscopic versus open surgery

Huynh Quang Khanh et al. Indian J Thorac Cardiovasc Surg. 2021 Jan.

Abstract

Purpose: There are not many studies comparing long-term oncological outcomes between video-assisted thoracoscopic surgery (VATS) and open surgery for mediastinal malignancies. This study aimed to compare perioperative and long-term outcomes of these two techniques in the treatment of mediastinal malignancies.

Methods: This is a retrospective study: patients with mediastinal malignancies underwent VATS or open surgery from 2010 to 2013 and were followed until 2019. The primary endpoints were long-term oncological outcomes, including tumor recurrence and mortality. Secondary endpoints were perioperative outcomes (operative duration, blood loss, pain, chest drainage duration, hospital length of stay, and complications).

Results: There were 36 patients in the VATS group and 49 patients in the open group. The median follow-up duration was 90 months. VATS significantly reduced operation time (84.6 versus 124.8 min), blood loss (59.8 versus 235.2 ml), postoperative pain score (4.9 versus 6.7), the duration of chest tube drainage (2.1 versus 3.1 days), and postoperative hospital stay (5.2 versus 8.0 days). The two groups were comparable regarding the recurrence rate (2.4 versus 2.1/100 person-years) and mortality rate (0.8 versus 0.9/100 person-years).

Conclusion: Compared with open surgery, VATS is less traumatic, reduces postoperative chest drainage, and shortens hospital stay with comparable long-term oncological outcomes. We advocate the VATS approach as a favored option for the resection of mediastinal malignancies.

Keywords: Malignancy; Mediastinal tumor; Sternotomy; Thoracotomy; Video-assisted thoracoscopic surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flowchart of patients’ enrollment and follow-up. VATS video-assisted thoracoscopic surgery
Fig. 2
Fig. 2
Kaplan-Meier analysis of recurrence-free survival across treatment groups. VATS video-assisted thoracoscopic surgery
Fig. 3
Fig. 3
Kaplan-Meier analysis of overall survival across treatment groups. VATS video-assisted thoracoscopic surgery
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Strollo DC, Rosado de Christenson ML, Jett JR. Primary mediastinal tumors. Part 1: tumors of the anterior mediastinum. Chest. 1997;112:511–522. doi: 10.1378/chest.112.2.511. - DOI - PubMed
    1. Cohen AJ, Thompson L, Edwards FH, Bellamy RF. Primary cysts and tumors of the mediastinum. Ann Thorac Surg. 1991;51:378–384. doi: 10.1016/0003-4975(91)90848-K. - DOI - PubMed
    1. Davis RD, Jr, Oldham HN, Jr, Sabiston DC., Jr Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44:229–237. doi: 10.1016/S0003-4975(10)62059-0. - DOI - PubMed
    1. Strollo DC, Rosado-de-Christenson ML, Jett JR. Primary mediastinal tumors: part II. Tumors of the middle and posterior mediastinum. Chest. 1997;112:1344–1357. doi: 10.1378/chest.112.5.1344. - DOI - PubMed
    1. Li WWL, van Boven WJP, Annema JT, Eberl S, Klomp HM, de Mol BAJM. Management of large mediastinal masses: surgical and anesthesiological considerations. J Thorac Dis. 2016;8:E175–E184. doi: 10.21037/jtd.2016.02.55. - DOI - PMC - PubMed

LinkOut - more resources