A COMPARATIVE-STUDY OF THORACOSCOPIC VS OPEN REMOVAL OF BENIGN NEUROGENIC MEDIASTINAL TUMORS

Study objective: of benign neurogenic mediastinal tumors (BNMTs). Desi gn: Retrospective comparative study of thoracoscopy and open thoracoto my. Setting: Patients underwent surgery at the thoracic surgical servi ces of two institutions from 1988 to 1994. Patients who underwent thor acoscopy were operated on more recently, 1992 to 1994. Patients who ha d thoracotomies underwent resection from 1988 to 1992. Patients: All a dult patients undergoing isolated removal of BNMTs at both institution s were included. Eleven patients underwent removal by posterolateral t horacotomy while six patients underwent thoracoscopic removal. Interve ntions: BNMTs were removed by standard posterolateral thoracotomy or b y three-hole thoracoscopic techniques with extension of incisions and conversion to an open procedure as necessary. Measurements and results : Larger tumors were more difficult to remove thoracoscopically Two ca ses of transient postoperative ptosis were noted among the patients wh o underwent thoracoscopy. Operative time was longer in the thoracoscop y group (171 vs 112 min; p<0.05). Postoperative stay was significantly shorter (2.6 vs 4.5 days; p<0.02) and return to work tended to be mor e rapid (4.3 vs 7.7 weeks; p=0.13) among patients who underwent thorac oscopy. Conclusions: Thoracoscopic resection of BNMTs can be achieved safely and effectively with more rapid postoperative recovery when com pared with an open thoracotomy approach to these mediastinal tumors.