Abstract
Introduction:
This video shows a total thoracoscopic resection of a large thymic cyst extending into the left neck in a 15-month-old boy.
Materials and Methods:
Our patient was found to have a mediastinal mass with right tracheal deviation on chest X-ray while undergoing work-up for a cough. He underwent a CT of chest that showed a large cystic mass, an echocardiogram that ruled out cardiac involvement, and an MRI that showed a large cystic mass in the right lobe of the thymus directly abutting the superior vena cava (SVC), left brachiocephalic vein (L BCV), and ascending aorta. It was also seen extending into the left neck splaying out the left internal jugular vein and left common carotid artery. He was taken for a right thoracoscopic mediastinal mass excision. He was placed in the supine position with a bump under his right side. The procedure was performed with a 5-mm camera port and three 3-mm stab incisions. The procedure was started by dissecting the cyst from the anterior chest wall using a combination of blunt dissection and electrocautery. The cyst was seen directly abutting the phrenic nerve, SVC, and L BCV laterally. The excision was carried out circumferentially staying directly on the cyst to avoid injury to surrounding structures. After freeing up the cyst distally, the cyst was then mobilized proximally and freed up from the left neck. The cyst was removed through one of the stab incisions and a right chest tube was placed at the end of the procedure.
Results:
The patient tolerated the procedure well. His chest tube was removed on postoperative day 2 and he was discharged home on postoperative day 4. The final pathology analysis returned as a thymic cyst.
Conclusion:
This video shows a successful thoracoscopic resection of a large thymic cyst extending into the left neck.
No competing financial interests exist.
Runtime of video: 4 mins 16 secs
Presented at IPEG, April 12, 2018, in Seattle, Washington.
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