Anterior Mediastinotomy: Is it Still a Reliable Diagnostic Method in the Era of Minimally Invasive Techniques? – A Retrospective Analysis of 73 Cases

Background: Rapid diagnosis of anterior mediastinal masses, which can arise from a wide range of diseases, is crucial for adopting appropriate treatment approaches. Methods: The demographic, radiological, operative, and pathological data of 73 patients who underwent diagnostic procedures—computed tomography (CT)-guided transthoracic fine-needle aspiration biopsy (TTFNAB), anterior mediastinotomy (AM), or video-assisted thoracoscopic surgery (VATS)—for anterior mediastinal masses between 2013 and 2023 were retrospectively analyzed. Results: The mean age of the patients was 45.29±18.51 years (range: 9–82), and 40 (54.8%) were male. The most common presenting symptom was chest pain (33%), while incidental detection occurred in 23.3% of cases. Initial biopsy procedures yielded a pathological diagnosis in 90.4% of cases, with lymphoma being the most common diagnosis (42.4%). Compared to surgical biopsies, TTFNAB had significantly lower diagnostic yield and shorter hospital stay but was performed in significantly older patients (p=0.025, p