Single centre experience in video-assisted thoracoscopic surgery resection of pleural schwannoma

Marco Chiappetta, Luca Pogliani, Dania Nachira, Maria Teresa Congedo, Leonardo Petracca Ciavarella, Edoardo Zanfrini, Elisa Meacci, Stefano Margaritora


Background: Intrathoracic neurogenic tumor account between 12% and 21% of all mediastinal masses and represent for 75% of posterior mediastinal tumors and the elective treatment of these tumors is surgical excision, also if the outcome after minimally invasive excision has not well described yet. Aim of this study is to analyze the outcome of surgically treated patients especially regarding the use of minimally-invasive techniques.
Methods: We conducted a retrospective study on 28 patients surgically treated for posterior mediastinal tumors during the period from 1/1/2007 to 31/12/2918. Data regarding the surgical technique, intra-operative findings and post-operative outcome were collected and retrospectively considered.
Results: Muscle sparing lateral thoracotomy was performed in 8 patients while 20 patients underwent minimally invasive surgery: 11 were subjected to three-port video-assisted thoracoscopic surgery (VATS); 1 to two-port VATS; 5 to uniportal VATS and 3 to robotic excision. Histology proved the masses to be benign neurogenic tumors in all cases. Complete surgical excision was achieved in 26 patients, in the other two there were no recurrences of disease during follow up.
Conclusions: VATS is a reliable approach with better post-operative results than traditional surgery in the treatment of neuronal tumors. The thoracotomy approach to these tumors should be reserved for large tumors or those with an involvement of the vertebral canal.