Anterior mediastinal masses: A single centre-based retrospective study

Abstract

Anterior mediastinal masses pose a serious challenge to anaesthetists and surgeons alike. It is sometimes associated with a severe cardiorespiratory compromise during surgery. The aim of this study was to evaluate the incidence of difficulty in airway management, intraoperative cardiorespiratory and postoperative complications in patients undergoing surgery for anterior mediastinal mass excision. We conducted a single centre-based retrospective observational study of the data of patients with anterior mediastinal mass who were treated surgically between February 2016 to January 2021. All the data of the patients were kept confidential. Data were collected from electronic medical records, operation theatre records, anaesthesia charts, intensive care unit (ICU) records, and discharge sheets. Demographic data, medical history, and preoperative imaging investigations were noted. The difficulty in airway management, amount of blood loss, blood transfusion, and other significant events during the intraoperative period were noted. In the postoperative period, the duration of mechanical ventilation, re-exploration, duration of ICU stay, hospital stay, and other complications were recorded. In our study, no patient suffered difficulty in intraoperative airway management(N=29). The intraoperative complication was seen in 13% of cases in the form of significant hemodynamic compromise. No patient underwent re-exploration. The mean blood loss during surgery was 455 ml. The mean duration of postoperative mechanical ventilation was 17 hours, and the ICU stay was 2.3 days. Postoperative complications were seen in 6% of cases (2 patients). Despite best management, some complications may happen in this subset of patients. A comprehensive multidisciplinary approach can minimize the risk of catastrophic hemodynamic and airway compromise during surgical excision.