Mediastinal surgery

The mediastinum is area in the centre of your chest. Sometimes, masses are noted to be present in this area. The most common site is the anterior mediastinum (within the chest but in front of the heart) when we usually need to take a sample of the tissue before we can know what it is and how to treat it. Rarely, cancers such as thymoma’s can develop in this area and surgery is usually the main form of treatment if there is a good prospect it can be removed completely. For most cancers, the traditional teaching is for the surgery to be undertaken through the front with the sternum (breast bone) opened and the mass and all the surrounding fat removed to ensure the lowest possible chance of it coming back.

There are alternative approached such as a keyhole approach, which in general is more suitable for smaller masses that are placed to either the right of left side. Currently I offer sub-xiphoid surgery where the operation is undertaken through a single keyhole at the bottom of the breastbone. Large scaled studies have indicated that the outcomes of minimal access surgery are as good as traditional open approaches.[1]

Whichever approach that is used, pain is usually well controlled and a drain is not usually required, allowing patients the option to return home on the same day.

If you need help or advice on which approach is best, please feel free to contact me to discuss.

Reference

Wang H, et al. Perioperative outcomes and long-term survival in clinically early-stage thymic malignancies: video-assisted thoracoscopic thymectomy versus open approaches. J Thorac Dis. 2016 Apr;8(4):673-9. doi: 10.21037/jtd.2016.03.05. PMID: 27114834; PMCID: PMC4824723.