Thoracoscopic removal of intrathoracic neurogenic tumors: A combined Chinese experience

Objective To review the surgical and clinical results of minimally invasive resection of intrathoracic neurogenic tumors using a video-assisted thoracoscopic te chnique. Summary Background Data Thoracoscopy has emerged as a possible means for diagnosing and managing va rious intrathoracic disorders. Benign intrathoracic tumors often are ideal lesions for resection using a video-assisted technique. The authors report on their combined experience with the thoracoscopic resection of 143 intrat horacic neurogenic tumors. Methods Between March 1992 and February 1999, 143 patients with intrathoracic neuro genic tumors were diagnosed and underwent resection using video-assisted th oracoscopic techniques in three teaching centers. Case selection, surgical technique, and clinical results were reviewed. Results The average age of the patients was 40.8 years; 57.3% were male. Thirty-eig ht patients (27%) had symptoms attributable to the masses. Seventy-two mass es were neurofibromas, 33 were neurilemmomas, 7 were paragangliomas, and 31 were ganglioneuromas. All but seven tumors were located in the posterior m ediastinum. The masses were on average 3.5 cm in greatest diameter. The mea n surgical time was 40 minutes, and the average hospital stay was 4.1 days. There were no major postoperative complications or recurrences to date. Ni ne patients reported paresthesias over the chest wall during a mean follow- up of 29 months. Conclusions Resection of intrathoracic neurogenic tumors using a thoracoscopic techniqu e based on standard surgical indications would seem to be appropriate. Most of these masses are benign and readily removed. For dumbbell tumors, a com bined thoracic and neurosurgical approach is mandatory.