Yıl 2020, Cilt 13 , Sayı 3, Sayfalar 629 - 634 2020-09-18

Primer mediastinal kist ve tümörler: 10 yıllık deneyim
Primary mediastinal cysts and tumors: 10 year experience

Tolga SEMERKANT [1] , Hıdır ESME [2]


Amaç: Mediastinal kist ve kitle nedeniyle opere edilen olguların semptomları, operasyon yöntemleri, postoperatif komplikasyon ve patolojilerini inceledik.

Gereç ve Yöntemler: 2009-2019 yılları arasında mediastinal kitlesi olan 90 olgu retrospektif olarak incelendi. Hastalar yaş, cinsiyet, şikayet, radyolojik yerleşim yeri, preop. tanı, ameliyat şekli, postoperatif komplikasyonlar, dren çekilme süresi, patoloji yönünden analiz edildi.

Bulgular: Olguların 39'u ( % 43,3 ) erkek, 51'i ( 56,7 ) kadındı. Ortalama yaş 44 idi. Hastaların % 48,9'unde şikayet yoktu. En fazla şikayet sırası ile göğüs ağrısı ( % 41,3 ), dispne ( % 34,8 ), öksürüktü ( % 15,2 ). Benign-malign ayrımı yapmadan olguların %74,4'i ön mediastende, %20'si arka mediastende ve % 5,6'ü orta mediasten yerleşimliydi. Hastaların % 8,9'unda transtorasik veya USG ile tru-cut biopsi yapılarak preoperatif tanı konuldu. Tanı veya tedavi amaçlı hastaların %61,1'ine torakotomi, % 21,1'ine sternotomi, %10'una VATS, %7,8'ine ise VATS ile başlanıp torakotomiye dönülerek opere edildi. Hastaların drenleri ortalama 5.günde çekildi. Postoperatif en fazla olan komplikasyon atelektazi ve sekresyondu. Mortalite %2,2 idi. Olguların postoperatif patolojisi % 63,3'ü benign, %36,7 maligndi. Patoloji en sık sırası ile %45,5 timik hastalıklar, %12,2 norojenik tumorler, %10 gelişimsel kistler, % 4 hodgking lenfoma, %4 hidatik kistti.

Sonuç: Radyolojik olarak mediastinal yapılara invazyon olmayan olgularda preoperatif tanı için invaziv girişimlere gerek yoktur. Lenfoma ve germ hücreli tümor olduğu düşünülmeyen ve etraf dokulara invazyon olmayan hastalarda cerrahi hem tanı hem tedavide etkin bir yöntemdir.

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.

  • Date H. Diagnostic strategies for mediastinal tumors and cysts. Thorac Surg Clin. 2009 Feb;19(1):29-35.
  • Sharma P. Jha V. Kumar N. Kumar R. Mandal A.Clinicopathological Analysis of Mediastinal Masses: A Mixed Bag of Non-Neoplastic and Neoplastic Etiologies. Turk Patoloji Derg. 2017;33(1):37-46.
  • Akshatha Rao Aroor. Rama Prakasha S.. Shubha Seshadri. Teerthanath S.. and Uppoor Raghuraj. A Study of Clinical Characteristicsof Mediastinal Mass. Published online 2014 Feb 3. doi: 10.7860/JCDR/2014/7622.4013
  • Juanpere S . Cañete N . Ortuño P . Martinez S . Sanchez G . Bernado L . A diagnostic approach to the mediastinal masses. Insights Imaging. 2013 Feb; 4 (1): 29-52.
  • Kubota K. Yamada S. Kondo T. Yamada K. Fukuda H. Fujiwara T. Ito M. Ido T. Br J Cancer.PET imaging of primary mediastinal tumours. Br J Cancer. 1996 Apr;73(7):882-6.
  • Iguchi T. Hiraki T. Matsui Y. Fujiwara H. Sakurai J. Masaoka Y. Uka M. Tanaka T. Gobara H. Kanazawa S. CT fluoroscopy-guided core needle biopsy of anterior mediastinal masses. Diagn Interv Imaging. 2018 Feb;99(2):91-97.
  • Pun YW. Moreno Balsalobre R. Prieto Vicente J. Fernández Fau L. Multicenter experience of video-assisted thoracic surgery to treat mediastinal cysts and tumors.Article in Spanish Arch Bronconeumol. 2002 Sep;38(9):410-4.
  • Yoshiki Kozu. Kenji Suzuki. Shiaki Oh. Takeshi Matsunaga. Yukio Tsushima. Kazuya Takamochi. Single Institutional Experience with Primary Mediastinal Cysts: Clinicopathological Study of 108 Resected Cases. Ann Thorac Cardiovasc Surg 2014; 20: 365–369
  • Ramakant Dixit. Narender Singh Shah. and Sabarigiri Vasan Harish.Diagnostic evaluation of mediastinal lesions: Analysis of 144 cases. Lung India. 2017 Jul-Aug;34(4):341-348. Bastos P. Magalhães A. Fernandes G. Cruz MR. Saleiro S. Gonçalves L. Piñon M. Primary cysts and tumors of the mediastinum. Rev Port Pneumol. 2007;13(5):659-73.
  • Bastos P. Magalhães A. Fernandes G. Cruz MR. Saleiro S. Gonçalves L. Piñon M. Primary cysts and tumors of the mediastinum. Rev Port Pneumol. 2007;13(5):659-73.
  • Biswajit Dubashi. Sanju Cyriac. and Sagar Gnana Tenali. Clinicopathological analysis and outcome of primary mediastinal malignancies — A report of 91 cases from a single institute. Ann Thorac Med. 2009 Jul-Sep; 4(3): 140–142.
  • Temes R. Chavez T. Mapel D. Ketai L. Crowell R. Key C. Follis F. Pett S. Wernly J. Primary mediastinal malignancies: findings in 219 patients. West J Med. 1999 Mar;170(3):161-6.
  • Bacha EA. Chapelier AR. Macchiarini P. Fadel E. Dartevelle PG. Surgery for invasive primary mediastinal tumors. Ann Thorac Surg. 1998 Jul;66(1):234-9
Birincil Dil en
Konular Cerrahi
Yayınlanma Tarihi Eylül 2020
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0002-5428-3742
Yazar: Tolga SEMERKANT (Sorumlu Yazar)
Kurum: konya eğitim araştırma hastanesi
Ülke: Turkey


Orcid: 0000-0002-0184-5377
Yazar: Hıdır ESME
Kurum: konya eğitim araştırma hastanesi
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 18 Eylül 2020

Bibtex @araştırma makalesi { patd645557, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2020}, volume = {13}, pages = {629 - 634}, doi = {10.31362/patd.645557}, title = {Primary mediastinal cysts and tumors: 10 year experience}, key = {cite}, author = {Semerkant, Tolga and Esme, Hıdır} }
APA Semerkant, T , Esme, H . (2020). Primary mediastinal cysts and tumors: 10 year experience . Pamukkale Tıp Dergisi , 13 (3) , 629-634 . DOI: 10.31362/patd.645557
MLA Semerkant, T , Esme, H . "Primary mediastinal cysts and tumors: 10 year experience" . Pamukkale Tıp Dergisi 13 (2020 ): 629-634 <https://dergipark.org.tr/tr/pub/patd/issue/55097/645557>
Chicago Semerkant, T , Esme, H . "Primary mediastinal cysts and tumors: 10 year experience". Pamukkale Tıp Dergisi 13 (2020 ): 629-634
RIS TY - JOUR T1 - Primary mediastinal cysts and tumors: 10 year experience AU - Tolga Semerkant , Hıdır Esme Y1 - 2020 PY - 2020 N1 - doi: 10.31362/patd.645557 DO - 10.31362/patd.645557 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 629 EP - 634 VL - 13 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.645557 UR - https://doi.org/10.31362/patd.645557 Y2 - 2020 ER -
EndNote %0 Pamukkale Tıp Dergisi Primary mediastinal cysts and tumors: 10 year experience %A Tolga Semerkant , Hıdır Esme %T Primary mediastinal cysts and tumors: 10 year experience %D 2020 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 13 %N 3 %R doi: 10.31362/patd.645557 %U 10.31362/patd.645557
ISNAD Semerkant, Tolga , Esme, Hıdır . "Primary mediastinal cysts and tumors: 10 year experience". Pamukkale Tıp Dergisi 13 / 3 (Eylül 2020): 629-634 . https://doi.org/10.31362/patd.645557
AMA Semerkant T , Esme H . Primary mediastinal cysts and tumors: 10 year experience. Pamukkale Tıp Dergisi. 2020; 13(3): 629-634.
Vancouver Semerkant T , Esme H . Primary mediastinal cysts and tumors: 10 year experience. Pamukkale Tıp Dergisi. 2020; 13(3): 629-634.