Thoracoscopic resection of posterior neurogenic tumors

Video-assisted thoracic surgery (VATS) may be used for resection of posteri or mediastinal tumors to avoid thoracotomy and shorten hospital stay. Betwe en October 1990 and Tune 1998, 23 patients had VATS resection of posterior neurogenic tumors. The 14 females and 9 males ranged in age from 14 months to 70 years, with a median of 35 years. Operation time ranged from 30 to 12 0 minutes (median, 83), and intraoperative complications were limited to mi nor problems as well as conversion to thoracotomy to enhance complete tumor resection in four cases. Tumor pathology included nerve sheath origin (20) and autonomic ganglia (3). There was only one malignant schwannoma. Tumor size ranged from 0.7 to 13 cm in diameter. Median chest tube days was 1 day (range, 1-4), and hospital stay was 2 days (range, 1-9). Postoperative com plications included transient paresthesia (three cases), ileus (two cases), pleural effusion (one case), and transient intercostal pain (one case). Po sterior neurogenic tumors may be resected safely using video-assisted techn iques. Conversion to thoracotomy to enhance complete resection is both poss ible and encouraged. The use of VATS seems to decrease hospital stay and mi nimize postoperative complications. In posterior neurogenic tumors without tumor extension to the spinal canal, VATS has become our preferred method f or resection.