Surgical management of mediastinal cysts

ObjectiveThe purpose of this study was to present our experience in management of mediastinal cysts and to compare our findings along with those from literature.MethodsA retrospective single-centre study was undertaken for 27 patients operated upon for mediastinal cysts in Zagazig University Hospital between 2004 and 2014. We analyzed demographics of patients, clinical presentation, location of lesions, type of procedures and histological diagnosis. Postoperative results regarding morbidity and mortality were reported.ResultsThere were 12 females (44.4%), and 15 males (55.6%) with mean age 40 ± 15.3 years. Eleven patients (41%) were asymptomatic. The main symptoms were dyspnea, cough and chest pain. CT scan was the main diagnostic tool. The surgical approach was through thoracotomy in 19, median sternotomy in 7 and combined neck collar incision and upper sternal split in one patient. We completely excised 10 bronchogenic cysts, 5 pericardial, 4 thymic, 4 cystic hygroma, 2 hydatid and one of each thyroid and cystic duct cysts. Most of the cysts (51.8%) were located in middle mediastinum. No mortality was reported. Regarding morbidity, one patient was re-explored for bleeding and another had wound infection. Both of them improved. No recurrence was seen during follow up.ConclusionSurgery for mediastinal cysts, even if asymptomatic is safe, reliable and curative modality with favorable outcome.