Napolitano Michael A, Werba Gregor, Desai Sonia A, Sparks Andrew D, Mortman Keith D
Department of Surgery, Division of Thoracic Surgery, 50430The George Washington University Hospital, Washington, DC, USA.
Am Surg. 2022 Feb;88(2):212-218. doi: 10.1177/0003134821989038. Epub 2021 Jan 30.
Mediastinal masses are commonly encountered by the thoracic surgeon. Few studies have reported on the frequency and characteristics of symptoms at presentation. The primary objective of this study is to determine how often patients present with symptoms from a mediastinal mass. The secondary objective is to determine if the presence of symptoms has an effect on outcomes after surgery.
A retrospective review of an institutional database was performed. All patients who underwent surgical resection of a mediastinal mass from 2013 to 2019 were included in the analysis. Medical records were reviewed for the presence or absence of symptoms preoperatively, and these cohorts were compared. Multivariable analysis was performed, adjusting for clinical variables to assess for differences between these cohorts.
70 patients underwent surgery for a mediastinal mass. The average age was 49.2 years, and 46 patients (65.7%) presented with symptoms. There were no significant differences in demographics between the symptomatic and asymptomatic groups. The most common symptom was dyspnea in 18 patients (22%), followed by chest pain (15 patients, 19%) and dysphagia (8 patients, 10%). When comparing symptomatic and asymptomatic patients, symptomatic patients had a larger tumor size (5.8 cm vs 3.8 cm, = .04) and a longer length of stay (2.0 days vs 1.2 days, = .02).
The majority of patients with mediastinal masses present with symptoms, with the most common symptom being dyspnea. Symptomatic patients are more likely to have a larger tumor and tend to have a longer length of hospital stay postoperatively compared to asymptomatic patients.
纵隔肿物是胸外科医生常见的病例。很少有研究报道其就诊时症状的发生频率及特征。本研究的主要目的是确定患者因纵隔肿物出现症状的频率。次要目的是确定症状的存在是否对手术后的结果有影响。
对机构数据库进行回顾性分析。纳入2013年至2019年所有接受纵隔肿物手术切除的患者。查阅病历以确定术前有无症状，并对这些队列进行比较。进行多变量分析，对临床变量进行调整以评估这些队列之间的差异。
70例患者接受了纵隔肿物手术。平均年龄为49.2岁，46例患者（65.7%）有症状。有症状组和无症状组在人口统计学上无显著差异。最常见的症状是呼吸困难，18例患者（22%）出现，其次是胸痛（15例患者，19%）和吞咽困难（8例患者，10%）。比较有症状和无症状患者时，有症状患者的肿瘤体积更大（5.8 cm对3.8 cm，P = .04），住院时间更长（2.0天对1.2天，P = .02）。
大多数纵隔肿物患者有症状，最常见的症状是呼吸困难。与无症状患者相比，有症状患者的肿瘤更可能更大，术后住院时间往往更长。
