Analysis of 50 cases of operated giant thoracic tumors.

PURPOSE To study the experience of the surgical treatment of giant thoracic tumors and the ways to overcome intraoperative and postoperative difficulties. METHODS A retrospective analysis of the data from 50 patients operated with giant thoracic tumors (26 men and 24 women; age range 0.5-77 years) was carried out. All patients were treated with different surgical resections. The resected tumors weighed between 628 and 2586 g (mean 1973) and the intraoperative blood loss was 400-1500 ml. RESULTS The tumor was successfully resected in all patients. Forty-eight (96%) patients were treated and discharged after the operation. Two (4%) patients developed postoperative pulmonary edema; one of them died due to disseminated intravascular coagulation (DIC) and the other one was discharged after full recovery. During follow up, one patient died of an abdominal metastasis of malignant mesothelioma 1 year after operation, and another one with mature teratoma died 4 months after the operation but the cause of death was unknown. The success of surgical resection was not related to the pathological tumor type. The surgical treatment was determined by the invasion and distant metastasis of giant thoracic tumors and surrounding tissues. CONCLUSIONS Patients with giant thoracic tumors often have severe symptoms that cannot be managed with conservative treatment. However, surgery can completely resolve the symptoms. In order to fully reveal the operative field, the incision has to be as close as possible to the tumor. Various surgical techniques, such as complete, segmented, or major portion incisions, can be used, and attention should be paid to avoid major intraoperative bleeding. Preventive measures against re-expansion pulmonary edema should be applied as soon as possible after the surgery.