Diagnostic and Surgical Outcomes of Mediastinal Tumors in Adults: What Place for Conventional Surgery in Resource-Limited Countries?

Abstract

Abstract Introduction: Mediastinum tumors are a heterogeneous group of tumors with diverse and varied presentations. We reviewed our experience with mediastinal tumors and the role of conventional surgery in their management in countries with limited resources. Materials and Methods: We retrospectively reviewed the medical records of patients with mediastinal tumors who underwent surgery at our Thoracic Surgery Department, University Hospital Center, Fez, Morocco, from January 2009 to December 2017. Results: A total of 56 patients underwent surgical resection for mediastinal tumors during the 9-year study period. Chest computed tomography imaging was obtained in all patients, and magnetic resonance imaging and technetium 99 (99-m Tc-methoxy-isobutyl-isomitril) scintigraphy were required in select patients. Sternotomy was the most frequently used surgical approach. Histopathology of the resected surgical specimens were 9 neurogenic tumors, 9 cystic benign tumors, 7 ectopic parathyroid adenomas, 8 teratomas, and 23 epithelial tumors of the thymus. Postoperative morbidity and mortality were 5.3% and 5.3%, respectively. All deaths were in patients with thymus epithelial tumors. Conclusion: Conventional surgery has acceptable morbidity and mortality and remains a viable therapeutic approach despite the advent of minimally invasive techniques like video-assisted surgery in recent decades.