Robot-assisted thoracoscopic resection of giant subcarinal bronchogenic cyst

Abstract

Operative management of bronchogenic cysts is indicated for symptomatic lesions. The standard operative approach entails a thoracotomy and resection of the cyst from the surrounding structure. In recent years however, operative management has shifted to minimally invasive approaches which are associated with shorter length of stay and better postoperative pain control. Here we present four patients with symptomatic giant subcarinal bronchogenic cysts. The first is a 49-year-old man who developed atrial fibrillation secondary to compression of the atria by a giant subcarinal cyst. He underwent a posterolateral thoracotomy and removal of the cyst with complete resolution of atrial fibrillation. His postoperative course was remarkable for readmission to the hospital a week after discharge for pain control that continued to limit his everyday activity for over a month after surgery. The second patient was a 59-year-old woman with persistent cough secondary to airway compression by a growing inflamed giant subcarinal cyst. A robot-assisted approach was utilized to resect the cyst. Last two patients underwent robot-assisted resection of symptomatic giant subcarinal bronchogenic cyst. Compared to the open approach, robotic resection was associated with shorter length of stay and improved pain control.