Surgical outcomes in mediastinal mature teratoma.

Background: This study was aimed at reporting the clinical characteristics and perioperative surgical outcomes of mediastinal mature teratoma managed in a single surgical unit.

Methods: This is a retrospective analysis of 35 cases of mediastinal mature teratoma cases managed in a tertiary level thoracic surgery center over 10 years. A comprehensive analysis of perioperative surgical outcomes including complications was performed.

Results: Males (n = 22, 62.8%) were predominant in the study group. Mean age of the cohort was 31.2 ± 13.3 years. The diagnosis was unruptured mature teratoma in 17(48.6%), ruptured mature teratoma in 8 (22.8%) and mature cystic teratoma in 10 (28.6%) patients. The mean duration from symptoms was 5.5 months (range: 1 - 84 months). Open surgery was done in 22 patients (62.8%) followed by video-assisted thoracoscopic surgery in 4 (11.4%) and robotic surgery in 9 patients (25.7%). Conversion from minimal access surgery to open surgery was in 2 patients (5.7%). The mean duration of intercostal chest drainage (ICD) was 6.3 ± 1.3 days, and mean hospital stay averaged 5.8 ± 2.7 days. Most common postoperative complication was prolonged post-operative air leak (> 7 days) in 5 patients (14.3%). The peri-operative mortality was in 1 (2.8%) patient. Ruptured teratoma was a strong predictor of postoperative complications (p = 0.008).

Conclusion: Complete surgical resection is primary and effective treatment modality for mediastinal mature teratoma. A tailored approach is needed, considering the factors like tumor size, location, and relation with surrounding structures.

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Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01882-8.