Mediastinal cyst involving the oesophagus: diagnosis and results of surgical treatment.

OBJECTIVE

To describe our experience with mediastinal cysts involving the oesophagus.

DESIGN

Retrospective study.

SETTING

University hospital, Italy.

SUBJECTS

11 patients who presented to our department with a mediastinal cyst from 1976-1994.

INTERVENTIONS

Excision of the mass through a posterolateral thoracotomy (n = 10) or by video-assisted thoracoscopy.

MAIN OUTCOME MEASURES

Morbidity and mortality.

RESULTS

8 patients presented with retrosternal or epigastric pain, three of whom had mild dysphagia. In the remaining 3 the tumour was asymptomatic and an incidental finding on a chest radiograph. Endoscopic ultrasonography and computed tomography (CT) allowed preoperative diagnosis of an extramucosal cyst in 5 of the 7 patients investigated by both tests. Masses were excised through a formal thoracotomy (n = 10) or by video-assisted thoracoscopy. Histological examination confirmed a benign cyst in all cases. There was no operative morbidity and nine patients are free of symptoms after a median follow-up of 2.3 years.

CONCLUSION

Excision, preferably by thoracoscopy, is the treatment of choice for mediastinal cysts that involve the oesophagus. Special attention should be paid to the vagal nerves, and as many as possible of the muscular layers of the oesophagus should be preserved.