DOI QR코드

DOI QR Code

Management of a Large Hypervascular Apicoposterior Mediastinal Mass Using the Purse-String Suture Technique in Robotic-Assisted Thoracoscopic Surgery: A Case Report

  • Juan Kim (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Jonggeun Lee (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Hyo Yeong Ahn (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine)
  • 투고 : 2023.05.08
  • 심사 : 2023.08.26
  • 발행 : 2024.01.05

초록

Complete resection of an apicoposterior mediastinal mass is essential due to the mass effect, which exerts pressure on adjacent organs. Recently, the use of minimally invasive surgery has had many advantages. In this report, we describe a case in which a large apicoposterior mediastinal hypervascular mass was managed using a purse-string suture technique during robotic-assisted thoracoscopic surgery (RATS). The patient, a 77-year-old woman, was diagnosed with a 6.2-cm apicoposterior mediastinal hypervascular solid mass originating from the branches of the right subclavian artery. The patient underwent RATS for treatment. To obtain an adequate view of the apex of the thoracic cavity, a needle aspiration was performed, followed by the application of a purse-string suture technique. This was done to reduce the size of the tumor and to prevent catastrophic events such as seeding or spillage of the cystic mass. The mass was histopathologically diagnosed as a schwannoma. The patient was discharged on the first postoperative day without experiencing any complications.

키워드

참고문헌

  1. Bouassida I, Zayene B, Zribi H, Abdelkbir A, Ayadi R, Marghli A. Mediastinal paraganglioma as a large dumbell tumor: A case report. Int J Surg Case Rep 2022;95:107160. https://doi.org/10.1016/j.ijscr.2022.107160 
  2. Demiroz SM, Sayan M, Celik A. Giant tumors of the posterior mediastinum: a narrative review of surgical treatment. Mediastinum 2022;6:36. https://doi.org/10.21037/med-21-39 
  3. Hartigan PM, Karamnov S, Gill RR, et al. Mediastinal masses, anesthetic interventions, and airway compression in adults: a prospective observational study. Anesthesiology 2022;136:104-14. https://doi.org/10.1097/ALN.0000000000004011 
  4. Chen K, Zhang X, Jin R, et al. Robot-assisted thoracoscopic surgery for mediastinal masses: a single-institution experience. J Thorac Dis 2020;12:105-13. https://doi.org/10.21037/jtd.2019.08.105 
  5. Xu S, Liu B, Wang X, et al. Robotic thoracic surgery of the posterior superior mediastinal mass. Ann Transl Med 2015;3:127. https://doi.org/10.3978/j.issn.2305-5839.2015.03.07 
  6. Zirafa CC, Melfi F. Robot-assisted surgery for posterior mediastinal mass. J Thorac Dis 2017;9:4929-31. https://doi.org/10.21037/jtd.2017.10.160 
  7. Dahal A, Malla JJ, Neupane D, et al. Large posterior mediastinal ganglioneuroma with intradural cervical spine extension: a rare case report and review of literature. Ann Med Surg (Lond) 2022;84:104833. https://doi.org/10.1016/j.amsu.2022.104833 
  8. Al-Mufarrej F, Margolis M, Tempesta B, Strother E, Gharagozloo F. Novel thoracoscopic approach to difficult posterior mediastinal tumors. Gen Thorac Cardiovasc Surg 2010;58:636-9. https://doi.org/10.1007/s11748-009-0542-x 
  9. Bakkum-Gamez JN, Richardson DL, Seamon LG, et al. Influence of intraoperative capsule rupture on outcomes in stage I epithelial ovarian cancer. Obstet Gynecol 2009;113:11-7. https://doi.org/10.1097/AOG.0b013e3181917a0c