A comparative study of thoracoscopic vs open removal of benign neurogenic mediastinal tumors.

STUDY OBJECTIVE To assess the relative benefit of thoracoscopy vs open thoracotomy in the removal of benign neurogenic, mediastinal tumors (BNMTs). DESIGN Retrospective comparative study of thoracoscopy and open thoracotomy. SETTING Patients underwent surgery at the thoracic surgical services of two institutions from 1988 to 1994. Patients who underwent thoracoscopy were operated on more recently, 1992 to 1994. Patients who had thoracotomies underwent resection from 1988 to 1992. PATIENTS All adult patients undergoing isolated removal of BNMTs at both institutions were included. Eleven patients underwent removal by posterolateral thoracotomy while six patients underwent thoracoscopic removal. INTERVENTIONS BNMTs were removed by standard posterolateral thoracotomy or by three-hole thoracoscopic techniques with extension of incisions and conversion to an open procedure as necessary. MEASUREMENTS AND RESULTS Larger tumors were more difficult to remove thoracoscopically. Two cases of transient postoperative ptosis were noted among the patients who underwent thoracoscopy. Operative time was longer in the thoracoscopy group (171 vs 112 min; p<0.05). Postoperative stay was significantly shorter (2.6 vs 4.5 days; p<0.02) and return to work tended to be more rapid (4.3 vs 7.7 weeks; p=0.13) among patients who underwent thoracoscopy. CONCLUSIONS Thoracoscopic resection of BNMTs can be achieved safely and effectively with more rapid postoperative recovery when compared with an open thoracotomy approach to these mediastinal tumors.