Mediastinoscopic and thoracoscopic resection combined with a sternum lift technique in a case of mature cystic teratoma localized under the left brachiocephalic vein

Abstract

Thoracoscopic surgery for anterior mediastinal tumors is difficult because the sternum can be a great obstacle to surgical maneuvers and impedes adequate thoracoscopic vision compared to that provided by median sternotomy. We performed mediastinoscopic and thoracoscopic resection by lifting the inferior portion of the sternum with a Laparolift in a 31-year-old female with mature cystic teratoma localized under the left brachiocephalic vein. Intraoperative bleeding was noted at a site of the thymic vein, and 850 ml of blood was lost due to the delayed thoracoscopic approach. Although thoracoscopic and mediastinoscopic resection of benign anterior mediastinal tumors through a xiphoid approach is useful due to the absence of postoperative pain that allows early discharge from the hospital, the operative bleeding may occur unexpectedly, which requires adequate measures such as rapid surgical treatment.