Outcomes of minimally invasive surgery for treatment of mediastinal neurogenic dumbbell tumors
Abstract
Background. Mediastinal dumbbell tumors are rare and can compress the spinal cord or
mediastinal structures. There is no single approach to the treatment of this
pathology.
The aim of our study was to improve the results of treatment of mediastinal
neurogenic dumbbell tumors by analyzing our own experience of surgical
interventions with development of an optimal approach for such tumors.
Material and methods. A retrospective analysis was performed on 14 patients who underwent surgery
for thoracic dumbbell tumors at our department during the period 2003 to 2019.
Removal of the tumor was performed both using the standard approach - a
combination of laminectomy with thoracotomy or cervicosternotomy, and
using minimally invasive techniques - a combination of hemilaminectomy
with thoracoscopy or supraclavicular access. The immediate and long-term results
of operations have been studied.
Results. The study included 14 patients, which accounted for 12.9% of all neurogenic
tumors of the mediastinum. In comparison with thoracotomy and
cervicosternotomy, the combination of laminectomy with VATS or supraclavicular
approach was accompanied by a decrease in pain syndrome, intraoperative
blood loss (p=0.013), complications (p=0.008), duration of
pleural drainage (p=0.015) and
hospitalization (p=0.005). There was
no postoperative mortality. At a mean follow-up of 68.6 months no patients
showed recurrence of the tumor.
Conclusion. For neurogenic dumbbell tumors a combination of hemilaminectomy with VATS
or supraclavicular access (if localized in the thoracic inlet) is advisable as
a surgical approach, which are characterized by low trauma and allow the
tumor to be removed in a single block and to avoid the potential danger of
recurrence.
Keywords:dumbbell tumors, laminectomy, mediastinum tumor, neurogenic tumors, thoracoscopy
Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
For citation: Podobed A.V., Zaretski S.V., Malkevich V.T. Outcomes
of minimally invasive surgery for treatment of mediastinal neurogenic dumbbell
tumors. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (1):
23-8. DOI: https://doi.org/10.33029/2308-1198-2021-9-1-23-28 (in Russian)
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