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Surgical Endoscopy
Published in: Surgical Endoscopy 3/2014

01-03-2014

Has there been a paradigm shift in mediastinal surgery from open to minimally invasive, and from magnetic resonance imaging (MRI) to positron emission tomography–computerized tomography (PET–CT) in the last decade?

Authors: Alper Toker, Suat Erus, Erkan Kaba, Serhan Tanju, Berker Ozkan

Published in: Surgical Endoscopy | Issue 3/2014

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Abstract

Objective

The purpose of this study was to investigate the effects of diagnostic and surgical developments in the complete resection of the mediastinal masses.

Methods

Of 313 patients, 236 underwent therapeutic or diagnostic complete resections. We analyzed age, gender, diagnostic interventions, neoadjuvant treatment, type of surgical intervention (sternotomy, video-assisted thoracic surgery [VATS], thoracotomy), pathology, duration of hospital stay, complications, mortality, and associated diseases. Patients were divided into two groups according to the period of operation: group A included patients who were operated on between January 2002 and January 2007; group B included patients who were operated on between January 2007 and January 2012.

Results

Resection with VATS increased significantly after 2007, from 17.7 to 35 % (p = 0.03). The rate of complications increased after 2007 (p = 0.03), which was apparent in non-VATS patients (p = 0.03). The use of magnetic resonance imaging (MRI) decreased from 29 to 15.5 % (p = 0.02) and positron emission tomography (PET)–computed tomography (CT) use increased from 1.6 to 25.2 % (p < 0.001).

Conclusions

We identified a paradigm shift in mediastinal mass surgery. PET–CT became a more preferred diagnostic method and MRI became less preferred. The rate of VATS resection doubled and sternotomy decreased. Complication rates increased in non-VATS due to an increase in extended resections.
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Metadata
Title
Has there been a paradigm shift in mediastinal surgery from open to minimally invasive, and from magnetic resonance imaging (MRI) to positron emission tomography–computerized tomography (PET–CT) in the last decade?
Authors
Alper Toker
Suat Erus
Erkan Kaba
Serhan Tanju
Berker Ozkan
Publication date
01-03-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 3/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3233-8

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