Safety and feasibility of a novel bronchoplasty-based approach for the resection of middle mediastinal tumors located beneath the carina: a real-world study

Background: Due to anatomical complexities, the surgical resection of middle mediastinal tumors located beneath the carina is particularly challenging. This real-world study aimed to evaluate a novel bronchoplasty-based approach for the resection of such tumors and to assess its safety and feasibility based on a retrospective cohort. Methods: We retrospectively reviewed patients with middle mediastinal tumors located beneath the carina who underwent a novel bronchoplasty-based approach at Shanghai Chest Hospital between January 2016 and December 2023. Perioperative outcomes and survival rates were assessed. Results: A total of 9 patients were included, and complete tumor resection was achieved in all cases. The median operative duration was 125 minutes [interquartile range (IQR), 107-184 minutes], and the median intraoperative blood loss was 100 mL (IQR, 100-200 mL). The median postoperative chest tube drainage duration and hospitalization were 4.0 days (IQR, 3.0-5.0 days) and 5.0 days (IQR, 5.0-7.0 days), respectively, while the incidence rate of postoperative complications was 22.2%. No perioperative mortality was observed. Over a median follow-up of 5.6 years, the 5-year cancer-specific survival and overall survival rates were 100.0% and 83.3%, respectively. Conclusions: The novel bronchoplasty-based approach appears to be safe and feasible for the resection of middle mediastinal tumors located beneath the carina.