16 de July de 2025

What is the mediastinum and what conditions may require surgery?

The mediastinum is a key anatomical area of the chest that, although little known to most people, plays a vital role. It is located between the lungs and houses organs such as the heart, the great vessels, the trachea, the esophagus, and the thymus gland. Various conditions can develop in this area and, in some cases, require surgical intervention. At barnaclínic+ thoracic surgery, we evaluate each case with a multidisciplinary approach and offer minimally invasive treatments whenever possible.

“Mediastinal surgery involves the resection of both benign and malignant lesions.”

Dr. Ricard Ramos – Thoracic Surgeon

What types of lesions can develop in the mediastinum?

The mediastinum is anatomically divided into anterior, middle, and posterior compartments, and depending on the location, different types of tumors or lesions may arise:

• In the anterior mediastinum, thymic tumors predominate, such as thymomas and thymic cysts.
• In the middle mediastinum, enlarged lymph nodes due to infections, mediastinal adenopathies, lymphomas, or metastases may be found.
• The posterior mediastinum is typically the site of neurogenic tumors or esophageal cysts.

Mediastinal pathology also includes mediastinitis, a rare but serious infection, and surgical approaches for conditions such as myasthenia gravis, which can benefit from a thymectomy.

“At barnaclínic+, we also perform surgery for myasthenia gravis, a neurological disease.”

Dr. Ricard Ramos

What are the symptoms of mediastinal diseases?

Many of these lesions are discovered incidentally during a chest X-ray or CT scan performed for another reason. However, if the mass grows or compresses nearby structures, symptoms may appear such as:

• Chest pain or a feeling of pressure.
• Shortness of breath or dyspnea.
• Persistent cough or voice changes (dysphonia).
• Difficulty swallowing (dysphagia).
• Symptoms of superior vena cava syndrome in more advanced cases.

Diagnosis: how we evaluate a mediastinal mass

To properly assess a mediastinal lesion, at barnaclínic+ we perform tests such as:

• Contrast-enhanced chest CT scan, to characterize the lesion and assess its extent.
• PET-CT, to determine whether the lesion is metabolically active.
• Magnetic Resonance Imaging (MRI), useful in cases with vascular involvement and lesion characterization.
• Image-guided biopsy or mediastinoscopy, which can be both diagnostic and therapeutic.

When is thoracic surgery recommended?

Thoracic surgery for the mediastinum is recommended when:

• A suspected or confirmed mediastinal tumor is identified.
• A symptomatic or high-risk cyst is diagnosed.
• There are persistent mediastinal adenopathies without a clear diagnosis.
• The patient has myasthenia gravis and removal of the thymus is indicated as part of the treatment.

“We can perform surgical resection of the thymus gland.”

Dr. Ricard Ramos

What kind of thoracic surgery do we offer at barnaclínic+?

Thanks to advances in minimally invasive thoracic surgery and robotic surgery, today we can operate on many of these lesions using techniques that reduce surgical impact. At barnaclínic+, we perform:

• VATS (Video-Assisted Thoracic Surgery): video-assisted surgery.
• RATS (Robotic Assisted Thoracic Surgery) – Robotic surgery: greater precision, less invasiveness, less pain, and better postoperative quality of life.

These techniques offer advantages such as reduced postoperative pain, faster recovery, and shorter hospital stays.
When necessary, we also use conventional approaches such as sternotomy, but in most cases, we achieve excellent results without the need for open surgery.

What to expect after surgery?

In general, recovery after mediastinal surgery with minimally invasive techniques is quick. Most patients are discharged within a few days and can return to their normal activities in less time. Results are especially positive when the intervention is performed early and in a specialized setting like barnaclínic+.
In conditions like myasthenia gravis, thymectomy can lead to significant symptom improvement and a reduction in the need for medication.

Have you been diagnosed with a lesion in the mediastinum? Here’s what you can do

We understand that a mediastinal mass diagnosis can be unsettling. But you’re not alone: at barnaclínic+ we have a team of thoracic surgery specialists, cutting-edge technology, and the expertise needed to offer you the best possible treatment.