Thoracoscopic removal of neurogenic mediastinal tumors in children

Purpose: The aim of this study was to evaluate the feasibility and advantages of thoracoscopic removal of neurogenic mediastinal tumors (NMTs) in children. Methods: From January 1998 to December 2001, 6 patients, ages 1.1 to 6.8 years (mean, 3.5 years), underwent thoracoscopic removal of NMT. A retrospective study was done to assess the type of anesthesia, conversions to standard thoracotomy, operative time, complications, and the current status of each patient. Results: General anesthesia using a Fogarty catheter as an ipsilateral bronchial blocker was utilized. Four 5-mm ports were placed in all patients. All NMTs were successfully removed without a need to convert to standard thoracotomy. The tumor was captured in an extraction bag, fragmented, and then removed through the trocar site, which had been enlarged up to 2.0-2.5 cm in each case. Pathologic diagnosis was neuroblastoma in 1 patient, ganglioneuroblastoma in 2, and ganglioneuroma in 3 patients. The mean operative time was 230 minutes. There was no need for transfusion and no serious complication related to this approach. All patients are alive at the time of writing, without any evidence of tumor recurrence. Conclusion: All tumors were successfully removed. Thoracoscopic surgery is a feasible, safe, and effective technique in the treatment for children with NMT.