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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A pesar del perfeccionamiento de las t&#233;cnicas de la imagen&#44; se requiere con frecuencia alg&#250;n procedimiento quir&#250;rgico para la valoraci&#243;n diagn&#243;stica y el tratamiento definitivo de las masas mediast&#237;nicas&#46; El alcance de la cirug&#237;a videotoracosc&#243;pica &#40;CVT&#41; en este campo no est&#225; todav&#237;a bien definido&#46; En el presente estudio se describe y se analiza la experiencia del Grupo Cooperativo de Cirug&#237;a Videotoracosc&#243;pica SEPAR &#40;GCCVT-SEPAR&#41;&#44; con el objetivo de conocer la utilidad de esta t&#233;cnica en el tratamiento de quistes y tumores mediast&#237;nicos</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Durante 2 a&#241;os y de forma prospectiva se han recogido datos de 1&#46;573 procedimientos videotoracosc&#243;picos consecutivos de 17 hospitales&#46; Se analizan los datos completos de 64 procedimientos practicados para el diagn&#243;stico y tratamiento de quistes y tumores del mediastino</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se obtuvo el diagn&#243;stico definitivo en todos los casos&#46; Hubo 19 tumores malignos y 45 lesiones benignas&#46; Se realizaron 25 resecciones completas &#40;39&#37;&#41;&#58; seis quistes pleuroperic&#225;rdicos&#44; cuatro quistes broncog&#233;nicos&#44; ocho tumores neurog&#233;nicos y otras lesiones benignas&#46; Las masas radiol&#243;gicamente mal definidas y las de localizaci&#243;n en el mediastino anterior y medio fueron operadas con m&#225;s frecuencia con fines diagn&#243;sticos&#44; mientras que las lesiones qu&#237;sticas y las s&#243;lidas bien delimitadas del mediastino posterior lo fueron m&#225;s bien con intenciones terap&#233;uticas&#46; El 11&#37; de los casos precis&#243; una conversi&#243;n a toracotom&#237;a&#44; debido principalmente a adherencias pleurales&#46; Hubo cuatro complicaciones &#40;6&#44;3&#37;&#41; y no hubo mortalidad en la serie&#46; La mediana de hospitalizaci&#243;n posquir&#250;rgica fue de 2&#44;5 d&#237;as&#46; El 7&#44;8&#37; de los procedimientos se realiz&#243; mediante cirug&#237;a ambulatoria</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La CVT se llev&#243; a cabo en m&#250;ltiples lesiones mediast&#237;nicas en Espa&#241;a&#46; Se seleccionaron las lesiones qu&#237;sticas y los tumores benignos para la resecci&#243;n&#46; Las lesiones mal delimitadas y malignas fueron diagnosticadas mediante biopsia&#46; La experiencia demuestra la eficacia y la se-guridad de esta t&#233;cnica para los casos seleccionados</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In spite of improvements in imaging techniques&#44; surgical procedures are often needed to diagnose and definitively treat mediastinal masses&#46; The range of application of video-assisted thoracic surgery &#40;VATS&#41; in this context is still poorly defined&#46; The present study describes and analyzes the experience of the Cooperative Group for Video-assisted Thoracoscopic Surgery of the Spanish Society of Pneumology and Thoracic Surgery &#40;GCCVT-SEPAR&#41;&#44; with the aim of determining the usefulness of the technique for treating mediastinal cysts and tumors</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">For 2 years we gathered information prospectively on 1&#44;573 consecutive VATS procedures in 17 hospitals&#46; The data from 64 procedures performed for diagnosis and treatment of mediastinal cysts and tumors are analyzed</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A definitive diagnosis was reached in all cases&#46; Nineteen were malignant tumors and 45 were benign lesions&#46; Twenty-five complete resections &#40;39&#37;&#41; were performed&#58; 6 pleuropericardial cysts&#44; 4 bronchogenic cysts&#44; 8 neurogenic tumors and other benign lesions&#46; Radiologically poorly defined masses and those located in the anterior and median parts of the mediastinum were most often the object of diagnostic procedures&#44; whereas cysts and well-defined solid lesions on the posterior mediastinum were usually the object of therapeutic interventions&#46; Eleven percent of the cases required conversion to thoracotomy&#44; mainly due to pleural adhesions&#46; Four complications &#40;6&#46;3&#37;&#41; were recorded and no deaths occurred&#46; The median hospital stay after surgery was 2&#46;5 days&#59; 7&#46;8&#37; of the procedures were performed on outpatients</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">VATS is performed on many mediastinal lesions in Spain&#46; Cysts and benign tumors are selected for resection&#46; Poorly defined and malignant lesions were diagnosed by biopsy&#46; The experience reported demonstrates the efficacy and safety of this technique for selected cases</p>"
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Journal Information
Vol. 38. Issue 9.
Pages 410-414 (September 2002)
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Vol. 38. Issue 9.
Pages 410-414 (September 2002)
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Experiencia multicéntrica de cirugía videotoracoscópica en el tratamiento de quistes y tumores del mediastino
Multicenter experience of video-assisted thoracic surgery to treat mediastinal cysts and tumors
Visits
9188
Y.W. Pun
Corresponding author
ypunmail@jazzfree.com

Correspondencia: Servicio de Cirugía Torácica. Hospital Universitario de la Princesa.Diego de León, 62. 28006 Madrid
, R. Moreno Balsalobre, J. Prieto Vicente, L. Fernández Fau, en representación del Gccvt-Separ *
Servicio de Cirugía Torácica. Hospital Universitario de la Princesa. Madrid
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Objetivo

A pesar del perfeccionamiento de las técnicas de la imagen, se requiere con frecuencia algún procedimiento quirúrgico para la valoración diagnóstica y el tratamiento definitivo de las masas mediastínicas. El alcance de la cirugía videotoracoscópica (CVT) en este campo no está todavía bien definido. En el presente estudio se describe y se analiza la experiencia del Grupo Cooperativo de Cirugía Videotoracoscópica SEPAR (GCCVT-SEPAR), con el objetivo de conocer la utilidad de esta técnica en el tratamiento de quistes y tumores mediastínicos

Método

Durante 2 años y de forma prospectiva se han recogido datos de 1.573 procedimientos videotoracoscópicos consecutivos de 17 hospitales. Se analizan los datos completos de 64 procedimientos practicados para el diagnóstico y tratamiento de quistes y tumores del mediastino

Resultados

Se obtuvo el diagnóstico definitivo en todos los casos. Hubo 19 tumores malignos y 45 lesiones benignas. Se realizaron 25 resecciones completas (39%): seis quistes pleuropericárdicos, cuatro quistes broncogénicos, ocho tumores neurogénicos y otras lesiones benignas. Las masas radiológicamente mal definidas y las de localización en el mediastino anterior y medio fueron operadas con más frecuencia con fines diagnósticos, mientras que las lesiones quísticas y las sólidas bien delimitadas del mediastino posterior lo fueron más bien con intenciones terapéuticas. El 11% de los casos precisó una conversión a toracotomía, debido principalmente a adherencias pleurales. Hubo cuatro complicaciones (6,3%) y no hubo mortalidad en la serie. La mediana de hospitalización posquirúrgica fue de 2,5 días. El 7,8% de los procedimientos se realizó mediante cirugía ambulatoria

Conclusiones

La CVT se llevó a cabo en múltiples lesiones mediastínicas en España. Se seleccionaron las lesiones quísticas y los tumores benignos para la resección. Las lesiones mal delimitadas y malignas fueron diagnosticadas mediante biopsia. La experiencia demuestra la eficacia y la se-guridad de esta técnica para los casos seleccionados

Palabras clave:
Cirugía videotoracoscópica
Tumores mediastínicos
Cirugía torácica
Objective

In spite of improvements in imaging techniques, surgical procedures are often needed to diagnose and definitively treat mediastinal masses. The range of application of video-assisted thoracic surgery (VATS) in this context is still poorly defined. The present study describes and analyzes the experience of the Cooperative Group for Video-assisted Thoracoscopic Surgery of the Spanish Society of Pneumology and Thoracic Surgery (GCCVT-SEPAR), with the aim of determining the usefulness of the technique for treating mediastinal cysts and tumors

Method

For 2 years we gathered information prospectively on 1,573 consecutive VATS procedures in 17 hospitals. The data from 64 procedures performed for diagnosis and treatment of mediastinal cysts and tumors are analyzed

Results

A definitive diagnosis was reached in all cases. Nineteen were malignant tumors and 45 were benign lesions. Twenty-five complete resections (39%) were performed: 6 pleuropericardial cysts, 4 bronchogenic cysts, 8 neurogenic tumors and other benign lesions. Radiologically poorly defined masses and those located in the anterior and median parts of the mediastinum were most often the object of diagnostic procedures, whereas cysts and well-defined solid lesions on the posterior mediastinum were usually the object of therapeutic interventions. Eleven percent of the cases required conversion to thoracotomy, mainly due to pleural adhesions. Four complications (6.3%) were recorded and no deaths occurred. The median hospital stay after surgery was 2.5 days; 7.8% of the procedures were performed on outpatients

Conclusions

VATS is performed on many mediastinal lesions in Spain. Cysts and benign tumors are selected for resection. Poorly defined and malignant lesions were diagnosed by biopsy. The experience reported demonstrates the efficacy and safety of this technique for selected cases

Keywords:
Video-assisted thoracic surgery
Mediastinal tumors
Chest surgery
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pp. 144

Los integrantes del Grupo Cooperativo de Cirugía Videotoracoscópica (GCCVT) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) se exponen en el anexo I

Copyright © 2002. Sociedad Española de Neumología y Cirugía Torácica
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