OUR DIAGNOSTIC AND THEARAPEUTIC SURGICAL APPROACHES TO MEDIASTINAL MASSES
Journal Title: Journal of International Dental and Medical Research - Year 2010, Vol 3, Issue 2
Abstract
The mediastinum is defined as the thoracic space that lies between the two pleural layers. It extends from the thoracic inlet to the superior surface of the diaphragm. It is bordered anteriorly by the internal surface of the sternum and posteriorly by the longitudinal spinal ligaments. The mediastinum comprises of important anatomical structures. Surgical treatments and the results of patients who had a pre-diagnosis of mediastinal masses were examined. A total of 93 patients who underwent surgery for a pre-diagnosis of mediastinal masses between June 2003 and June 2008 were retrospectively reviewed. Preoperative evaluations, operative procedures and results of the patients were examined. Of the 93 patients, 47 were females and 46 were males. The age range was 5-76 years, while the mean age was 46.5 years. Mediastinal lesions were mostly located in the anterior mediastinum. Cough and chest pain were observed as the two main symptoms in symptomatic patients. The surgical procedures performed were mediastinoscopy, posterolateral thoracotomy, median sternotomy, and anterior mediastinotomy. Post-operative histopathological examination of collected specimens resulted in a variety of pathologic diagnoses. Two patients developed incision wound infection, whereas one patient, known to have thymoma, died on the 16th post-operative day as a result of respiratory muscle insufficiency. Two patients diagnosed with osteosarcoma and chondrosarcoma metastasis died four months after surgery due to primary pathologies. The surgical procedure used in the diagnosis and treatment of mediastinal masses is very important. The surgical approach is determined according to localization. Operative mortality is very low. Surgical management of mediastinal masses is suggested to be the most appropriate approach since histopathological diagnosis and treatment can be achieved synchronously in many patients.
Authors and Affiliations
Cemil Yorgancilar, Ozgur Karakurt, Osman Tilkan, Sedat Demircan
Keywords
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