Thoracoscopic excision of mediastinal bronchogenic cysts: Results in 20 cases

Background. We present our experience with thoracoscopic resection of media stinal bronchogenic cysts in adults. Methods. From November 1990 to September 1993, 20 patients with mediastinal bronchogenic cysts were operated on by thoracoscopy. The average cyst size was 4.9 cm, and the largest diameter was 10 cm. Ten cysts were located in the middle mediastinum and 10 in the posterior mediastinum. Two cysts were complicated. Results. Thirteen bronchogenic cysts were resected completely by thoracosco py. We had to convert thoracoscopy into thoracotomy because of bleeding in two cases and because of major adhesions to vital structures in five cases. There were no operative deaths and no postoperative complications. Mean ho spital stay was significantly less in the completely thoracoscopically trea ted group. Long-term follow-up (range, 4.5 to 7.5 years) showed no late com plications and no recurrence. Conclusions. Preoperative complications, intraoperative injuries, and major adhesions to vital structures seem to be the only unfavorable conditions t o thoracoscopic treatment of bronchogenic cysts. This study found encouragi ng results for thoracoscopic excision of mediastinal bronchogenic cysts in selected patients. (C) 2000 by The Society of Thoracic Surgeons.