Video-assisted thoracoscopic surgery of mediastinal bronchogenic cysts in adults: a single-center experience

Ann Thorac Surg. 2004 Sep;78(3):987-91. doi: 10.1016/j.athoracsur.2004.03.092.


Background: Mediastinal bronchogenic cysts are rarely diagnosed in adults, hence surgical experience is limited particularly with regard to video-assisted thoracoscopic surgery. In support of the thoracoscopic approach we report our single-center experience in this rare entity.

Methods: Between June 1995 and December 2002, a nonselected series of 12 consecutive patients presenting with mediastinal bronchogenic cysts underwent video-assisted thoracoscopic surgery. Six cysts (50%) had been diagnosed 2 to 22 years prior, only three of which became symptomatic. In asymptomatic patients (n = 7) surgery was performed because of increasing cyst size (n = 3), patient's request (n = 3), or suspected metastasis (n = 1).

Results: Mediastinal bronchogenic cysts were correctly diagnosed by computed tomography in 83% (10/12) and by magnetic resonance imaging in 100% (9/9). Using a three-trocar technique thoracoscopic surgery was successfully performed in 11 of 12 cases (92%). We noted no signs of acute cyst infection. No serious postoperative complications were observed. In 1 patient conversion to open thoracotomy was necessary due to extensive pleural adhesions. In another case thoracoscopic excision of the cyst wall was incomplete. Patients with thoracoscopic excision were discharged after a median of 5.5 days (range 4 to 14 days). No recurrences or complications were observed during a mean follow-up of 40.5 months.

Conclusions: Considering the low conversion and complication rate in our series, video-assisted thoracoscopic surgery should be the primary therapeutic choice among adults with symptomatic mediastinal bronchogenic cysts. Surgical intervention in patients with asymptomatic and uncomplicated cysts appears optional.

MeSH terms

  • Adult
  • Bronchogenic Cyst / congenital
  • Bronchogenic Cyst / diagnosis
  • Bronchogenic Cyst / surgery*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mediastinal Cyst / congenital
  • Mediastinal Cyst / diagnosis
  • Mediastinal Cyst / surgery*
  • Middle Aged
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted / methods*
  • Tomography, X-Ray Computed