Evaluation of our surgical approaches in mediastinal masses

Aim: Mediastinal masses represent various pathological formations in the mediastinum, the central compartment of the thoracic cavity. These masses may originate from various tissues and structures, leading to very different clinical presentations and diagnostic difficulties. In this study, age, symptoms, radiological findings, diagnostic methods and pathological diagnoses at the end of surgery were evaluated in cases diagnosed with mediastinal masses in Dicle University Thoracic Surgery Clinic, and it was investigated whether there would be mediastinal lesions with different characteristics and proportions from the international and national literature in mediastinal masses. Methods: In our study, we retrospectively evaluated the age, gender, tumour localisation, radiological findings, diagnostic methods, histopathological diagnosis, surgical technique, postoperative treatment of 155 patients who were operated in Dicle University Medical Faculty Hospital Thoracic Surgery Clinic for mediastinal mass between January 2014 and January 2023. Results: In our study, 155 patients were analysed. 61.3% of the patients were female, and the mean age was 38.37 years. The most common symptoms were cough, dyspnoea and chest pain. The most common preoperative diagnosis was Myasthenia Gravis. The most common lesions were thymoma, thymic hyperplasia and bronchogenic cysts. Benign lesions were primarily seen in women, while malignant lesions were common in men. Malignant lesions were more frequently located in the anterior mediastinum. The postoperative complication rate was 17.4% and was higher in malignant patients and those with comorbidities. The mortality rate was 21.2% in malignant patients. Conclusion: Early diagnosis of mediastinal masses and correct surgical approach are important. Non-symptomatic patients should not be ignored. Minimally invasive surgical methods can accelerate recovery and reduce complications. Customisation of surgical techniques according to the patient's condition and lesion increases treatment success. Neuromuscular diseases such as myasthenia gravis should be carefully managed. Early diagnosis and multidisciplinary approach in the treatment of malignant diseases improve survival. Keywords: Mediastinal masses, surgical approach, complications, malignancy