Thoracoscopy-assisted mini-open approach for resection of neurogenic tumors arising at the thoracic apex

Objective: To present an anterior thoracoscopy-assisted mini-open approach for minimally invasive resection of neurogenic tumors located at the thoracic apex. Methods: From February 2002 to December 2013, 18 consecutive patients underwent resection of neurogenic tumors located at the thoracic apex using a thoracoscopyassisted mini-open approach at our institution. There were 6 male and 12 female patients with an average age of 36.1 ± 10.3 years. Tumors extended into the vertebral canal with a dumbbell appearance in 3 patients. Results: Complete surgical excision was achieved in all patients. Tumor location was T1-2 in 5 patients, T2-T3 in 10, and T3-4 in 3. Mean operating time was 49.7 ± 15.9 minutes, and mean intraoperative blood loss was 72.6 ± 38.4 mL. Chest tube removal occurred at an average of 2.8 ± 1.1 days after surgery, and mean hospital stay was 7.6 ± 2.0 days. Mean intrathoracic neurogenic tumor extension was 5.7 ± 2.2 cm. For patients with dumbbell tumors, laminectomy was performed first to remove the intraspinal component of the tumor. No evidence of tumor recurrence was observed in any case at an average of 56.8 ± 39.1 months after surgery. Conclusion: A thoracoscopy-assisted mini-open approach can provide a simple, safe, minimally invasive, and practical treatment option for patients with neurogenic tumors located at the thoracic apex. This approach has the advantages of minimal trauma, shortened recovery time, and risk reduction of complications.