Mediastinal cysts are common lesions, affecting children, as well as adults. They account for 20-30 % pathological mediastinal masses. The treatment is surgical, including extirpation, respectively enucleation of the
cyst.
AIM OF THE STUDY: Assessment of the author's patient group and overview of current literature data.
MATERIAL AND METHODS: Histological examination confirmed
pericardial cysts in 7 subjects (63.6%), brochogenic
cysts in 3 (27.3%) subjects and a
thymic cyst in one subject (9.1%). The commonest location was anterior mediastinum - 7 subjects (63.6%), whereas upper mediastinum was the
cyst site in 3 (27.3%) subjects and posterior mediastinum in 1 (9.1%) subject.
Thoracotomy was indicated in 3 subjects, one subject was indicated for lung resection for
carcinoma using
thoracotomy and the
pericardial cyst was a secondary known diagnosis, one patient was operated using
sternotomy. 6 patients were indicated for videothoracoscopic (VTS) procedures and a decision to convert to
thoracotomy was taken in 2 of these subjects. The patients were discharged from hospital 4-12 days after
thoracotomy (the mean of 6.67 days), 3-4 days after VTS (the mean of 3.25 days), while the patient undergoing
sternotomy was discharged on the postoperative Day 8. The mean size of the
cysts removed using
thoracotomy was 78 x 55 mm and the mean size of the
cysts removed using VTS was 50 x 29 mm.
CONCLUSION: The surgical technique for expected
mediastinal cysts should be selected based on the
cysts location, rather than on their size. The main objective is to indicate each
mediastinal cyst for VTS (shorter duration of hospitalization) and eventual conversion to
thoracotomy does not cause any delays or complications. Also asymptomatic
cysts should be indicated for surgery.