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Thoracoscopic resection of mediastinal bronchogenic cysts in adults

^a University of Rome ‘Sapienza’, Department of Surgery and Transplantation, ‘P. Stefanni’ Thoracic Surgery Policlinoco ‘Umberto I’, Viale del Policlinico 155, Rome, Italy
^b University of Tor Vergata, Rome, Italy

Received 22 October 2008; received in revised form 11 March 2009; accepted 24 March 2009.

^_* Corresponding author. Tel.: +39 06 4461971; fax: +39 06 49970735. (Email: tiziano.degiacomo{at}tin.it).

Objective: Bronchogenic cysts are uncommon congenital anomalies of foregut origin usually located within the mediastinum and the lung and rarely diagnosed in adults. Surgical excision is recommended to establish diagnosis based on histologic examination, alleviate symptoms if present, and prevent future complications. Thoracoscopic approach is becoming the primary therapeutic option. Methods: Between January 1995 and July 2008, 30 patients with mediastinal bronchogenic cyst (MBC) underwent thoracoscopic operation (19 male, 11 female with a mean age of 39 years, range 19–59 years). Symptoms were present in 11 patients (37). Results: The cysts averaged 5.2 cm in their greatest diameter (range 3–10.5 cm). In two cases thoracoscopy was converted to thoracotomy because of major pleural adhesions. There were no operative deaths and no intra-operative complications. Postoperative course was uneventful in all cases and the 28 patients who underwent thoracoscopy were discharged after a mean of 3.7 days (range 2–5 days). Conclusions: Considering the low conversion and complication rate, thoracoscopic excision of bronchogenic mediastinal cyst should be considered the primary therapeutic option.

Key Words: Video-assisted thoracoscopy • Bronchogenic cyst • Mediastinum