Abstract:

Objective: To present the investigations related to the symptoms, surgical techniques, post-operative complications and pathologies of the cases with mediastinal cysts and masses. Material and Methods: Ninety cases with mediastinal cysts were evaluated retrospectively between 2009-2019. Patients were investigated regarding age, gender, complaints, radiological location of cysts, pre-operative diagnosis, type of surgeries, post-operative complications, removal of drains and pathologies. Results: Of cases, 39 (43.3%) were men, and 51 (56.7%) were women. Mean age was 44, and 48.9% had no complaints. The most common complaints reported were, in turn, chest pain (41.3%), dispnea (34.8%) and cough (15.2%).Without any differentiation between benign and malignant cases, 74.4, 20 and 5.6% of the cysts were located in anterior, middle and posterior mediastinum, respectively. Preoperative diagnosis was performed by transthoracic or USG tru-cut biopsy in 8.9% of patients. For diagnostic and threapeutic purposes, 61.1%, 21.1% and 10% of patients were operated through thoracotomy, sternotomy and video-assisted thoracic surgery (VATS) respectively, while 7.8% were operated with first thoracotomy and then VATS. The drains were removed approximately on 5th day. The most common post-operative complications were atelectasis and secretion, and mortality rate was found as 2.2%. The post-operative pathologies were benign in 63.3% and malignant in 36.7% of the cases. Frequencies of pathologies were respectively as follows: thymic diseases (45.5%), neurogenic tumors (12.2%), developmental cysts (10%), Hodkgin’s lymphomas (4%) and hydatid cysts (4%). Conclusion: There is no need for invasive radiological interventions with the mediastinal structures in non-invasive cases for pre-operative diagnosis.Surgery is an effective method in the diagnosis and treatment of patients without invasion to surrounding tissues, and for whom no lymphomas and germ-cell tumors are considered.

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