39220 Resection of mediastinal tumor

Name of the Procedure:

Resection of Mediastinal Tumor

• Common Names: Mediastinal tumor removal
• Medical Terms: Mediastinal mass resection

Summary

The resection of a mediastinal tumor is a surgical procedure to remove abnormal growths located in the mediastinum, which is the area in the chest between the lungs that houses various vital structures including the heart, trachea, esophagus, and major blood vessels.

Purpose

This procedure is primarily performed to:

• Diagnose and treat a mass in the mediastinum.
• Alleviate symptoms caused by the tumor, such as chest pain, cough, or respiratory issues.
• Prevent the tumor from becoming malignant or spreading to other areas.

Indications

• Presence of symptomatic or asymptomatic mediastinal mass confirmed by imaging studies.
• Signs of compression or invasion of nearby structures causing symptoms like difficulty breathing or swallowing.
• Biopsy results suggesting malignancy or potential for malignancy.

Preparation

• The patient may be required to fast for several hours before surgery.
• Preoperative assessments include complete blood work, imaging studies (CT or MRI), and pulmonary function tests.
• Medications may need to be adjusted, particularly blood thinners and other medications that affect bleeding.

Procedure Description

1. Anesthesia: The procedure is performed under general anesthesia.
2. Incision: A surgical incision is made in the chest, such as through a median sternotomy (cutting through the sternum) or thoracotomy (incision on the side of the chest), depending on the tumor's location.
3. Tumor Removal: The surgeon carefully dissects and removes the tumor, avoiding injury to the surrounding organs and tissues.
4. Closure: The incision is closed with sutures or staples, and a drainage tube may be placed to prevent fluid buildup.
5. Post-operative Care: The patient is monitored closely for any immediate complications.

Duration

The surgery typically takes between 2 to 4 hours, depending on the complexity and size of the tumor.

Setting

The procedure is performed in a hospital operating room, followed by a stay in the intensive care unit (ICU) for close monitoring.

Personnel

• Surgeon: Performs the tumor resection.
• Anesthesiologist: Manages anesthesia and monitors vital signs.
• Nursing Staff: Assists during surgery and provides postoperative care.

Risks and Complications

• Common Risks: Infection, bleeding, prolonged air leaks, reaction to anesthesia.
• Rare Risks: Injury to nearby structures (e.g., heart, esophagus, blood vessels), respiratory complications, persistent pain.

Benefits

• Relief from symptoms such as chest pain and breathing difficulties.
• Reduced risk of the tumor becoming malignant or spreading.
• Improved overall quality of life and possibly increased longevity.

Recovery

• Patients usually stay in the hospital for several days post-surgery.
• Pain management with prescribed medications.
• Gradual return to normal activities is usually expected within 4 to 6 weeks.
• Follow-up appointments to monitor recovery and ensure no tumor recurrence.

Alternatives

• Watchful Waiting: For small, asymptomatic tumors without signs of malignancy.
• Radiation Therapy: May be considered for certain types of tumors.
• Chemotherapy: Used particularly for malignant tumors or in conjunction with surgery.

Pros and Cons of Alternatives

• Watchful Waiting: Pros – Non-invasive; Cons – Potential for tumor to grow or become symptomatic.
• Radiation Therapy: Pros – Non-surgical; Cons – May not be as effective for large tumors, potential side effects.
• Chemotherapy: Pros – Can target cancer cells throughout the body; Cons – Systemic side effects, usually combined with other treatments.

Patient Experience

• The patient will be asleep during the procedure due to general anesthesia.
• Post-procedure, the patient might experience pain and discomfort at the incision site, managed with pain medications.
• Gradual increase in activity as recovery progresses, with specific instructions from healthcare providers to aid in healing and prevent complications.