Thoracoscopy as routine approach for anterior mediastinal diseases

We performed VATS for diagnostic or therapeutic purposes in 48 patients with anterior mediastinal diseases. Five patients were converted to an open approach and excluded. Therapeutic resection was performed because of primary (n=14) or refractory (n=4) myasthenia gravis, pericardial cyst (n=2), and massive thymic hyperplasia (n=1). Assessment of resectability of a huge thymoma was performed in 2 patients. Diagnostic biopsy was performed in 11 patients with undetermined masses (diagnostic yield 91%), and in 9 patients for restaging of previously treated lymphoma (diagnostic yield 100%). Associated procedures were performed in 9 patients: 4 drainages of pleural effusion, 4 lung biopsies, 1 pericardial window. There was neither mortality nor major morbidity. All patients considered as excellent (n=34) or very good (n=9) the cosmetic effect of the operation. VATS seems to offer some advantages over the standard approaches due to its low invasiveness;and its versatility as diagnostic or therapeutic tool.