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CURRENT ISSUE

№1' 2022

SURGERY

International Medical Journal, Vol. 28., Iss. 1, 2022, P. 21−24.

DOI (https://doi.org/10.37436/2308-5274-2022-1-4)

THORACOSCOPIC SURGERY OF LARGE AND INVASIVE MEDIASTINAL TUMORS

A. A. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

Mediastinal neoplasms are a key problem in the practice of thoracic surgeons. An asymptomatic course is the feature of these formations. The most common manifestations of the disease are the tumor large size, resulting in a compression of vital structures that are located in the mediastinum. The question arises on the use of minimally invasive surgical methods in the resection of large tumors of the mediastinum. The advantages of thoracoscopic access over open surgery are less painful and traumatic, better cosmetic effect, faster rehabilitation period, especially in the elderly patients and those with pathology of the cardiopulmonary system. This study is based on the materials of clinical examination and surgical treatment of 40 patients treated at the Shalimov National Institute of Surgery and Transplantology in 2019−2021. All the patients underwent computed tomography or magnetic resonance imaging of the chest and abdomen, fibrogastroduodenoscopy. The great variability of the location of neoplasms in the mediastinum requires an individual approach in the diagnosis and supervision of patients. The treatment of large (diameter > 5 cm), small (diameter < 5 cm) and invasive mediastinal tumors, which were removed by thoracoscopic method, was analyzed. These studies indicate the safety of treatment of large mediastinal tumors with thoracoscopic access, as the length of stay of patients after surgery in the hospital was minimal, and the number of complications was insignificant. According to the analysis results, it was concluded that thoracoscopic interventions for large and invasive mediastinal tumors did not significantly prolong the duration of surgery, its post−recovery. Evidence of the safety and reliability of thoracoscopic surgery is the absence of significant complications.

Key words: mediastinal tumors, thoracoscopic surgery, histological structure of neoplasms.

REFERENCES

1. Total thoracoscopy in the resection of mediastinal mass: report of 45 cases / Q. Wang et al. Chin. J. Minim. Invasive Surg. 2010. № 10. R. 486−487.

2. Gonzalez−Rivas D. Evolving thoracic surgery: from open surgery to single port thoracoscopic surgery and future robotic. Chin. J. Cancer Res. 2013. № 25 (1). R. 4−6. doi:10.3978/j.issn.1000−9604.2012.11.02

3. Current application of thoracoscopy in children / K. Tsao et al. J. Laparoendosc. Adv. Surg. Tech. 2008. № 18. R. 131−135.

4. Ulaş A. B., Aydın Y., Eroğlu A. Comparison of video−assisted thoracoscopic surgery and thoracotomy in the treatment of mediastinal cysts. Türk. Gögüs. Kalp. Damar. Cer. Derg. 2018. № 30, 26 (2). R. 265−271. doi: 10.5606/tgkdc.dergisi.2018.15233

5. Agasthian T., Lin S. J. Clinical outcome of video−assisted thymectomy for myasthenia gravis and thymoma. Asian Cardiovasc. Thorac. Ann. 2010. № 18. R. 234−239. doi: https://doi.org/10.1177/0218492310369017

6. Primary mediastinal masses: analysis of 64 case / A. Sarper et al. Türk. Gögüs. Kalp. Damar. Cer. Derg. 2001. Vol. 9. P. 153−155.

7. Early and mid−term outcomes of trans−sternal and video−assisted thoracoscopic surgery for thymoma / I. Manoly et al. Eur. J. Cardiothorac. Surg. 2014. Vol. 45. e187−93. doi: https://doi.org/10.1093/ejcts/ezu077

8. Li Y., Wang J. Experience of video−assisted thoracoscopic resection for posterior mediastinal neurogenic tumours: a retrospective analysis of 58 patients. ANZ J. Surg. 2013. Vol. 83. P. 664−668. doi: https://doi.org/10.1111/j.1445−2197.2012.06174.x

9. Comparative Short−Term Clinical Outcomes of Mediastinum Tumor Excision Performed by Conventional VATS and Single−Port VATS: Is It Worthwhile? / C. F. Wu et al. Medicine (Baltimore). 2015. Vol. 94 (45). e1975. doi: 10.1097/MD.0000000000001975

10. Analysis of 31 cases with video−assisted treatment of mediastinal masses / Y. J. Dong et al. Chin. J. Endosc. 2011. Vol. 17. P. 175−176.