Objective     To investigate the clinical outcomes of complete video-assisted thoracoscopic surgery (VATS) in treatment of mediastinal tumor

especially for bulky and invasive masses. Methods       A total of 113 patients (including 51 males and 62 females

at a median age of 50

ranging from 9 to 78) undergoing VATS for primary mediastinal tumor in our department from January 2011 to December 2014 were enrolled in this study. The diameter of the mass ranged from 1.5 to 13 cm

with a median of 4 cm. Peri-operative indicators were recorded and evaluated statistically. ResultsSuccessful operation was carried out in all the cases by VATS

with intra-operative bleeding amount of 10 to 800 mL (median amount 100 mL). The hospital stay ranged duration from 2 to 18 d (median duration 5 d). The intra-operative duration ranged from 40 min to 330 min

with median of 90 min. For the 28 cases with masses 6 cm in size (24.8%)

no peri-operative death or related complications were found

neither tumor recurrence during follow-up. But the operative time was prolonged and intra-operative bleeding volume was increased (P0.001)

but there was no change in hospital stay of length when compared with the cases with mass with diameter 6 cm. No mortality and complication occurred for 4 cases of invasive tumor (3 cases of malignant thymoma and 1 of teratoma) under VATS

but tumor recurrence was seen in 1 case during follow-up. Conclusion      VATS can be widely used in the surgery for mediastinal tumor

and bulky and invasive mediastinal masses are not its contraindication. The efficacy of VATS for bulky and invasive mass is paralleled with that of open surgery. Meanwhile

VATS leads mini-invasiveness

less pain

shortened hospital stay and less complication. VATS is a safe

efficient and economical treating strategy for patients with bulky and invasive mediastinal tumor.