Thoracoscopy in paediatric patients with mediastinal lymphangiomas: 10 years of surgical experience in a single centre.

Objectives: To summarize the clinical features of mediastinal lymphangiomas in paediatric patients and to compare the outcomes of open and minimally invasive surgical techniques.

Methods: The clinical data of 65 patients with mediastinal lymphangiomas who were hospitalized at the Department of Thoracic Surgery of Beijing Children's Hospital, Capital Medical University and underwent tumour resection between January 2013 and December 2023 were retrospectively analysed. Patient age, sex, tumour size, tumour location, tumour classification, tumour morphology, operative time, estimated bleeding volume, duration of hospitalization, number of postoperative days with a chest tube, average daily chest tube drainage volume, postoperative complications and follow-up conditions were summarized.

Results: Sixty-five patients, including 39 males and 26 females, ranging from age 2 months to 10 years (mean age 3.90 years) were included. Twenty-three patients underwent open surgery, and 42 underwent minimally invasive surgery. Five patients required conversion to open surgery. Compared with open surgery, minimally invasive surgery was associated with a significantly shorter operation time, a lower estimated bleeding volume, and fewer hospitalization days. There was no significant difference in postoperative complication rates, number of postoperative days with a chest tube or average daily chest drainage volume.

Conclusions: Mediastinal lymphangiomas are uncommon mediastinal tumours, and most patients present with respiratory symptoms; however, others have no symptoms. The proper use of preoperative imaging data could aid the differential diagnosis of the tumours. Surgical treatment is both practical and safe. Minimally invasive surgery can successfully reduce surgical trauma and should be encouraged since the view of the operative field is wider and clearer, which makes tumour separation easier.