Thoracoscopy for Diagnosis and Excision of Mediastinal Masses in Children

We review our experience with the thoracoscopic approach to mediastinal masses with regard to technical feasibility and complications. Ten children aged 3 to 16 years had 12 thoracoscopic procedures for 5 anterior and 5 posterior mediastinal masses. Ten procedures were completed thoracoscopically and two converted to immediate thoracotomy. A third patient required a delayed thoracotomy for postoperative bleeding. A tissue diagnosis was made in all five thoracoscopic biopsies. Four patients did not require chest tubes, and those undergoing thoracoscopic procedures and not requiring postoperative chemotherapy were discharged between day 1 and day 3. Thoracoscopic biopsy and excision of mediastinal masses is technically possible with good results. Anterior mediastinal masses in this series were best approached from the right side. Large masses may necessitate conversion for bleeding or assessment of resectability.