VIDEOTHORACOSCOPY FOR THE MANAGEMENT OF MEDIASTINAL MASS LESIONS

Background: The indications for video-assisted thoracescopy have stead ily expanded during recent years and include now the management of var ious mediastinal disorders. Methods: Until now we have used videothora coscopy for the diagnosis or treatment of mediastinal mass lesions in 28 patients. The indication for the procedure was bilateral or unilate ral mediastinal adenopathy in 16, a suspected malignant anterior media stinal mass lesion in six, and a presumable benign tumor of the poster ior or anterior mediastinum in six patients. Results: Video-assisted t horacoscopy provided an accurate tissue diagnosis in all patients with adenopathy and in all but one patient with a malignant mass lesion of the anterior mediastinum. It further allowed complete excision of all benign tumors of the anterior or posterior mediastinum. There were no intra- or postoperative complications, but conversion to open thoraco tomy was necessary in one patient. Conclusions: Video-assisted thoraco scopy is a valuable adjunct to traditional surgical techniques for the diagnosis of malignant mediastinal disease and may overcome some of t he limitations of mediastinoscopy and mediastinotomy. In the future, i t may become the procedure of choice for the resection of small benign tumors of the anterior or posterior mediastinum.