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[Minimally invasive surgery for cervico-mediastinal tumors: the choice of surgical approach].

OBJECTIVE
To improve postoperative outcomes in patients with cervico-mediastinal tumors using minimally invasive surgical approaches.


MATERIAL AND METHODS
A retrospective analysis included 67 patients with cervico-mediastinal tumors who underwent surgery between 2002 and 2020. Outcomes of conventional surgeries (n=29), VATS (n=17), supraclavicular approach (n=19) and their combination were analyzed.


RESULTS
Minimally invasive approaches were characterized by significantly less blood loss (p<0.001), complication rate (p<0.001), duration of postoperative drainage (p<0.001) and hospital-stay (p<0.001). There was no postoperative mortality. No patient had tumor recurrence throughout the follow-up period (median 35 months).


CONCLUSION
VATS is advisable for tumors <6 cm localized predominantly in the mediastinum (>50% of volume). Supraclavicular approach is preferred mainly for cervical tumors. Minimally invasive surgical approaches are followed by more favorable early postoperative outcomes in patients with cervico-mediastinal tumor compared to traditional technique.