by Kohnle D

Definition

The mediastinum is an area in the chest between the sternum and the spine in back. A mediastinal tumor resection removes abnormal tissue in this area.

Regions of the Lung
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Reasons for Procedure

Tumors in this area can put pressure on heart, lungs, spine and esophagus. It can also effect nearby nerves and blood vessels. This surgery can help to remove the tumors to ease any problems they may have caused. It is often part of treatment for cancer in this area.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, such as:

  • Damage to the areas surrounding the tumor, including the heart, lungs, and spinal cord
  • Fluid collecting between the lung tissue lining and the wall of the chest cavity
  • Lung collapse
  • Drainage, infection, or bleeding

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Alcohol use
  • Chronic diseases, such as diabetes or obesity
  • Use of blood thinning medicine (anticoagulant or antiplatelet)
  • Use of nonsteroidal antiinflammatory medicine

What to Expect

Prior to Procedure

Before the surgery, your doctor may take images of structures inside your body using:

Leading up to the surgery:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
  • Arrange for someone to drive you home from the hospital.
  • Arrange for help at home.

Anesthesia

General anesthesia —you will be asleep during the procedure

Description of the Procedure

To remove the tumor, the doctor will make one large, central incision in the chest, an incision between the ribs, or several small incisions. If several small incisions are made, a camera will be inserted into one incision. The camera will allow the doctor to view the area via monitor. Through the other incisions, surgical tools will be inserted.

Tubes may be inserted into your chest. These tubes will help to drain fluid and air from the chest cavity. The incisions will be closed with staples or stitches.

Immediately After Procedure

The breathing tube will be removed. You will be monitored closely for any complications from the procedure.

How Long Will It Take?

About 1 to 4 hours depending on the type of surgery

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medicine.

Average Hospital Stay

This surgery is done in a hospital setting. The usual length of stay is 4 days. Your doctor may choose to keep you longer if problems arise.

Post-procedure Care

At the Hospital

Deep breathing exercises and coughing will help your lungs recover.

At Home

Intense activity like heavy lifting will be limited during recovery.

Call Your Doctor

Alert your doctor to any problems such as:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Pain that you cannot control with the medications you've been given
  • Cough, difficulty breathing, or chest pain
  • Persistent nausea and/or vomiting
  • Loss of appetite
  • Pain and/or swelling in your feet, calves, or legs
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES

American Cancer Society  http://www.cancer.org 

National Cancer Institute  http://www.cancer.gov 

CANADIAN RESOURCES

BC Cancer Agency  http://www.bccancer.bc.ca 

Canadian Cancer Society  http://www.cancer.ca 

References

Flores RM. Surgical management of primary mediastinal germ cell tumors. The Cardiothoracic Surgery Network website. Available at: https://www.ctsnet.org/article/surgical-management-primary-mediastinal-germ-cell-tumors. Accessed January 26, 2021.

Germ cell tumors. Brigham and Women's Hospital website. Available at: https://www.brighamandwomens.org/lung-center/diseases-and-conditions/germ-cell-tumors. Accessed January 26, 2021.

Liu HP, Yim AP, et al. Thorascopic removal of intrathoracic neurogenic tumors: a combined Chinese experience. Ann Surg. 2000;232(2):187-190.

6/3/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use  : Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

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