Thoracoscopic treatment of bronchogenic cyst

A central bronchogenic cyst was excised thoracoscopically from a 44-year-old woman in whom a tumor had been pointed out in the left upper posterior mediastinum at a screening examination. Since the tumor was diagnosed to be benign, only conservative follow-up was undertaken, but the patient consulted our department desiring active therapy. On the basis of the chest CT and MRI findings a bronchogenic cyst was diagnosed. Under general anesthesia and mechanical ventilation of one lung, the thoracoscope was inserted into the thoracic cavity revealing in the left upper posterior mediastinum a cyst which was excised thoracoscopically. While coagulation was performed gingerly with an electric scalpel, the tumor was detached sharply and bluntly with a pair of scissors. The postoperative course was uneventful with little wound pain or scar formation. Hitherto bronchogenic cysts have been treated by resection after thoracotomy. Although this is an easy procedure, a relatively large operative scar is left and considerable wound pain may develop. In contrast, thoracoscopic treatment is characterized by minimal surgical invasiveness, little postoperative wound pain, and small scars. These advantages suggest that this technique may be indicated for benign mediastinal tumors, particularly cysts.