Mediastinal tumors patients treatment (one center experience)

Purpose of a study: to analyze the possibility results of surgical treatment of patients with mediastinal tumors. Material and methods . From 2006 to 2024, 278 patients (97 (34.89%) men and 181 (65.11%) women) with mediastinal tumors various interventions were performed. The age of the study participants ranged from 15 to 79 years, average age of patients was (49.8 ± 11,8) years old. In 96 cases, open interventions were performed, in 182 cases, mini invasive. In 219 (78.77%) patients, the tumor was localized in the anterior mediastinum, in 58 (20.86%) in the posterior mediastinum, in 1 (0.35%) in the anterior and posterior mediastinum. Results . The tumor was completely removed using sternotomy in 59 patients (21.22%), thoracoscopy in 134 (48.20%), thoracotomy in 18 (6.47%), dual-port thoracoscopy in 16 (5.75%), single-port access in 5 (1.79%), VATS intervention in 4 (1.43%), cervicotomy with partial sternotomy in 2 (0.71%), and clamshell in 1 (0.35%). Partial tumor resection was performed in 16 (5.75%). In 13 patients (4.68%), the volume of intervention was expanded due to tumor invasion or ingrowth into the vessels of the lung, pericardium, lung tissue, or chest wall. Postoperative complications occurred in 20 patients (7.19%). The mortality rate was 2.15% (6 patients). Conclusion . Surgical interventions in patients with mediastinal tumors are highly effective and have a low incidence of intra- and postoperative complications and mortality. When planning a surgical intervention, preference should be given to mini invasive interventions as low-traumatic, shorter in duration and highly radical, comparable to “open” surgeries. If mini invasive intervention is impossible, an “open” version of the operation can be considered, including with expansion of the volume when the tumor grows into the lung tissue, vessels, pericardium. Tumor debunking intervention are applicable for large tumors to reduce their volume, eliminate compression of the trachea, bronchi, vessels and carry out further treatment (chemotherapy, radiation therapy).