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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
56th Annual Meeting Abstracts


Minimally-Invasive Resection of Foregut Duplication Cysts and Pericardial Cysts in Adults
Denis Gilmore MD, Michael S. Kent, MD, Malcolm M. Decamp, MD, Sidhu P. Gangadharan, MD
Beth Israel Deaconess Medical Center, Boston, MA

PURPOSE OF STUDY

Foregut duplication cysts and pericardial cysts are rare congenital abnormalities which may not present until adulthood.  Video-assisted thoracic surgery (VATS) has supplanted the traditional open (thoracotomy or sternotomy) approach as the primary strategy for resection of these anomalies at our institution.  This study compares the outcomes of the two approaches.

 

METHODS USED

We retrospectively reviewed all consecutive cases of surgical resections of foregut duplication cysts and pericardial cysts performed at a single institution from January 1993 through July 2008. Indications for operation, final pathologic diagnosis, length of stay, and perioperative complication rates were analyzed.

 

SUMMARY OF RESULTS

15 cases were approached with a VATS technique; 7 were performed with an open approach.  There was one conversion to thoracotomy in the minimally-invasive group.  There was no statistically-significant difference in the types of cysts resected with either technique. (Table 1)   The indications for operations were also similar between groups, with 33% of VATS cases and 29% of open cases performed for incidentally-detected, asymptomatic cysts. (Table 2)  There was a significant decrease in the duration of chest tube drainage (1.1 vs. 2.5 days; p = 0.001) as well as overall length of stay (2.6 vs. 5.0 days; p = 0.002) in the VATS cases.  There were no deaths in the series, and the only perioperative complication noted was a single red cell unit transfusion requirement in one patient from the open group.


CONCLUSIONS

Minimally-invasive resection of foregut duplication and pericardial cysts may be accomplished with similar outcomes and shorter hospital stays when compared to an open surgical approach.

 

TABLES AND CHARTS

 

VATS n=15

Open

n=7

Pericardial cyst

5

2

Bronchogenic cyst

8

4

Esophageal duplication cyst

2

0

Indeterminate

0

1

Table 1  Final Pathology

 

 

VATS

Open

Incidental finding

5

2

Chest pain

9

3

Shortness of breath

2

3

Pneumonia

1

2

Cough

2

0

Palpitations

1

1

Atrial Fibrillation

1

2

Table 2  Preoperative symptoms


 

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