J Korean Neurosurg Soc.  2017 Feb;60(2):257-261. 10.3340/jkns.2016.0909.004.

One Stage Posterior Minimal Laminectomy and Video-Assisted Thoracoscopic Surgery (VATS) for Removal of Thoracic Dumbbell Tumor

• Nam KH
• Ahn HY
• Cho JS
• Kim YD
• Choi BK
• Han IH

• KMID: 2374889
• DOI: http://doi.org/10.3340/jkns.2016.0909.004

Abstract

OBJECTIVE
This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations.
METHODS
Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed.
RESULTS
The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each.
CONCLUSION
One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.

Keyword

Thoracic dumbbell tumor; Laminectomy; VATS; One-stage operation

MeSH Terms

Early Ambulation
Female
Follow-Up Studies
Hemangioma
Humans
Laminectomy*
Male
Methods
Neurilemmoma
Neurofibroma
Operative Time
Pain, Postoperative
Postoperative Complications
Pulmonary Atelectasis
Retrospective Studies
Thoracic Surgery, Video-Assisted*

Figure

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  Fig. 1 Intraoperative thoracoscopic finding shows a round mediastinal mass extruding over a diaphragm at T12/L1. M: mass, D: diaphragm, L: lung.

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  Fig. 2 Schematic illustration of one stage posterior minimal laminectomy and VATS for removal of thoracic dumbbell tumor. VATS: video-assisted thoracoscopic surgery.

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  Fig. 3 A: Preoperative gadolinium-enhanced MR image showing a well-enhanced dumbbell shaped tumor with a neuroforaminal extension in the left paravertebral space and posterior mediastinum at T2/3. B: Postoperative T2-weighted MR image shows no remnant tumor and partial laminectomy state reserving lateral facet. MR: magnetic resonance.

Reference

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