Thoracoscopic excision of asymptomatic posterior mediastinal ganglioneuroma. A case series study

Amr A Abdelwahab; Heba Salem; Ahmed G Elkhouly

Amr A Abdelwahab Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
Heba Salem Department of Chest, Faculty of Medicine, Tanta University, Tanta, Egypt
Ahmed G Elkhouly Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt

Keywords: Ganglioneuroma, posterior mediastinum, videothoracoscopy, VATS

Abstract

Background

Posterior mediastinal ganglioneuroma is the most frequent type of neurogenic tumors, and usually it is asymptomatic. The surgical approach to excise it may differ from center to center based on the surgeon's experience as well as the size of tumor. We aim to present our center's experience and short-term outcomes in surgical excision of posterior mediastinal ganglioneuroma.

Methods

This retrospective case series study, from June 2019 till December 2022, included 9 asymptomatic patients with mean age of 31± 5 years who expressed lesion in the posterior mediastinum. The mean size of the tumor was 5.3±3.6 cm in maximal dimensions.

Results

There were 7 males and 2 females with mean age was 31± 5 years, the excision by video-assisted thoracoscopy (VATS) was employed in 8 patients and conventional thoracotomy was carried out in 1 case. The mean operative time was 57±14 minutes with mean operative blood loss 50±10 ml. The mean postoperative chest tube drainage was 120±80 ml and no complications related to the procedures were observed. The average time of hospital stay after VATS treatment was 2 days, while after thoracotomy it was 5 days and patient suffered from ptosis that eventually recovered after 1 month with supportive treatment. Histopathological examination confirmed benign nature of ganglioneuroma in all cases.

Conclusions

Thoracoscopic excision of asymptomatic posterior mediastinal neurogenic tumor is safe, feasible and reduces postoperative pain, however, open technique might be considered for large-sized tumor to minimize the possible complications.