Should Spring Water Cysts of the Mediastinum Require Excisional Resection?

Complete surgical excision is the standard therapy for mediastinal cysts. Translucent cysts containing crystal-clear fluid are called “spring water cysts.” We considered that these cysts can be treated adequately using fenestration with minimal bleeding and damage to existing structures. We experienced a case of mediastinal spring water cyst fenestrated under video-assisted thoracoscopy with a miniaturized endoscope (mini-VATS), instead of excisional resection. Fenestration of the non-neoplastic mediastinal cyst under mini-VATS might be a less invasive radical procedure and an alternative to complete resection. We discuss the indication for surgery and the surgical procedure for non-neoplastic mediastinal cyst with crystal-clear fluid.