Outcomes of minimally invasive surgery for mediastinal neurogenic tumors

Abstract

To improve postoperative outcomes in patients with mediastinal neurogenic tumors by using of minimally invasive surgical approaches. A retrospective analysis included 108 patients who underwent surgery for mediastinal neurogenic tumors for the period 2001-2019. Short-term outcomes of conventional and minimally invasive (VATS, supraclavicular approach and their combination with laminectomy) surgeries were analyzed. Paravertebral tumor in posterior mediastinum was diagnosed in 71 patients, apical neoplasm - 34 patients, anterior mediastinal tumor - in 3 patients. Thirteen patients had dumbbell tumors. VATS was applied in 61 (56.5%) patients, thoracotomy - 22 (20.4%) cases, supraclavicular approach - 4 (3.7%) patients, combination of VATS and supraclavicular approach - 2 (1.9%) patients, cervicosternotomy - 10 (9.3%) cases, combination of VATS and laminectomy - 2 (1.9%) patients, thoracotomy and laminectomy - 3 (2.8%) cases, supraclavicular approach and laminectomy - 1 (0.9%) patient, cervicosternotomy and laminectomy - 3 (2.8%) patients. Regardless location of tumor, minimally invasive surgery reduced blood loss, perioperative morbidity, duration of drainage and hospital-stay. Most posterior neurogenic tumors can be resected via VATS. Supraclavicular approach is recommended for tumors extending in cervical region. Combination of laminectomy and VATS or supraclavicular approach are appropriate for patients with dumbbell tumors.