International Medical Journal, Vol. 21., Iss. 4, 2015, P. 28−32.
DIAGNOSIS AND TREATMENT TACTICS AT MEDIASTINAL NEOPLASIA
V. T. Zaytsev Institute of General and Urgent Surgery (NAMS), Ukraine
Variable manifestations of the clinical course, difficulty in the diagnosis of mediastinal tumors and cysts characterize this pathology as one of the most difficult chapters of thoracic surgery. Tumors and cysts of the mediastinum have been known to surgeons for a long time, they are the cause of extremely severe physical and mental suffering of the patients, and often pose a threat to the life of the patients. Providing surgical care to the patients with tumors and cysts of the mediastinum is a difficult and is not always solvable task, one of the main roles in which is played by timely diagnosis and specialized surgical care. Mediastinal tumors are difficult to diagnose and treat because they often have a long asymptomatic period of growth and clinical manifestations in the form of compression of the mediastinum occurring with the tumor enlargement. The so−called mediastinal compression syndrome is a serious problem for management in the perioperative period, especially alarming is tracheobronchial obstruction, significantly increasing the anesthetic and operating risk. In view of the histogenesis of tumors, more than a hundred of their morphological variants can occur. At the same time, topography of the heart, great vessels, trachea, esophagus does not allow accurate preoperative diagnosis, verification of the diagnosis and determining the treatment policy. Accurate information about the frequency of occurrence of various tumors of the mediastinum is not available. According to some authors, it makes 2 cases per 1 million population, or 0.5−7 % of all tumors. From classical studies it is known that clinical diagnosis of mediastinal tumors is extremely difficult, and the frequency of individual symptoms described by various authors, range from 20 to 80%. Access to and the amount of surgery cannot always be determined according to the studies and changes in the performance of audit and evaluation of mediastinal tumor size and its relation to surrounding structures.
Key words: mediastinal neoplasia, diagnosis, surgery, videothoracoscopy.