Thoracoscopic management of mediastinal tumors in children: a single-center experience with mid-term outcomes.

BACKGROUND

Mediastinal tumors in children represent a heterogeneous and complex group of diseases with various embryological origins and a relatively high rate of malignancy compared to adults. Thoracoscopic surgery has increasingly been used for both diagnosis and treatment. This study aimed to evaluate the clinical characteristics, imaging findings, and mid-term outcomes of thoracoscopic management of mediastinal tumors in children.

METHODS

This retrospective case series included 12 patients diagnosed with mediastinal tumors who underwent thoracoscopic surgery at our hospital from August 2020 to March 2024.

RESULTS

The mean age at surgery was 7.27 ± 5.69 years (male: female ratio = 2:1). Clinical presentations were diverse, including asymptomatic cases (3), recurrent pneumonia (3), lymphadenopathy or paraneoplastic syndrome (5), and pleural effusion (1). Tumor locations included the anterior superior mediastinum (3 cases), middle mediastinum (3 cases), and posterior mediastinum (6 cases). Four patients (33%) received preoperative chemotherapy. Thoracoscopic procedures included biopsy in 3 patients (mean operative time: 61.67 min) and complete tumor resection in 9 patients (mean operative time: 106 min). The conversion rate to open surgery was 0%. The mean duration of postoperative mechanical ventilation was 1.7 ± 1.2 days, chest tube duration was 3.75 ± 2.92 days, and hospital stay was 11.0 ± 11.2 days. Histopathological findings included neuroblastoma (3 cases), ganglioneuroma (3 cases), lymphoma (3 cases), teratoma (2 cases), and thymoma (1 case). No local recurrence was observed during the 24-month follow-up period.

CONCLUSIONS

Thoracoscopic management is a safe, feasible, and effective approach for the diagnosis and treatment of mediastinal tumors in children, providing a minimally invasive option with favorable clinical recovery.