Minimally invasive surgery for mediastinal tumors Abdelkbir A, Labidi A, Abdennadher M, Zribi H, Zairi S, Marghli A

Introduction: Surgery has an essential role in the treatment of mediastinal tumors. Some of these tumors are accessible by various minimally invasive approaches, but the majority of them are still accessed by standard thoracic approaches (sternotomies and thoracotomies). Thoracoscopy retains an important place. Patients and methods: This is a retrospective study of cases of mediastinal tumors operated on by thoracoscopy at the department of thoracic surgery of Abderrahmen Mami Hospital over a period of 20 years. Results: Between 2000 and 2020, 101 patients underwent thoracoscopic surgery for mediastinal tumors. They were 61 women and 40 men (sex ratio: 0.65). The average age was 40 years. The mediastinal mass consisted of a thymoma in 22 cases, a thymic carcinoma in 2 cases, a thymic hyperplasia in 11 cases, a thymic cyst in 9 cases, a choriocarcinoma in 1 case, an ectopic parathyroid adenoma in 4 cases, a neurogenic tumor in 11 cases, an ectopic goiter in 1 case, bronchogenic cyst in 6 cases, coelomic cyst in 8 cases, mesothelial cyst in1 case, paraesophageal cyst in 4 cases, pleuropericardial cyst in 5 cases, leiomyoma in 1 case, lymphoma in 3 cases, sarcoma in 2 cases, seminoma in 1 case, teratoma in 5 cases. Four patients underwent surgery for myasthenia without thymic mass. The procedure consisted of a biopsy for 9 patients. The approach was exclusive videothoracoscopy in 53 cases. The postoperative course was complicated for 5 patients. Post Operative and per operative mortality was null. Conclusion: minimally invasive approches have an important place in the management of mediastinal tumors with a lower morbidity and mortality.