The Effect of Surgical Method and the Type of Mediastinal Infection on the Prognosis of Patients: A Retrospective Cohort Study

Background This study retrospectively compares the prognosis of patients with mediastinal abscess (MA), classified as Types A and B, who underwent different surgical treatments. The goal is to provide insights into the clinical management of MA. Methods We analyzed patients treated for deep neck infection (DNI) and MA at our center from December 2018 to January 2024. MA, which involves infection spreading from the cervical fascial plane to the mediastinum, is also referred to as descending necrotizing mediastinitis. The study examined differences in etiology, cervical space infection, surgical methods, and prognosis between Type A and Type B MA. Additionally, we compared outcomes between patients who underwent mediastinal surgery alone and those who received combined cervical-thoracic surgery. Results The study included 154 patients, 47 of whom were identified with DNI (n = 24) and MA (n = 22). The average recovery time for oral intake in Type A MA was 5.13 ± 7.72 days, while it was 23.40 ± 22.28 days for Type B MA (P = 0.042). Patients who underwent combined cervical-thoracic surgery showed faster recovery (5.80 ± 6.73 days) compared to those who had mediastinal surgery alone (27.13 ± 23.73 days) (P = 0.039). Conclusion Recovery time for oral intake was significantly longer in Type B MA compared to Type A. Patients with MA without DNI also recovered faster than those with MA and DNI. Overall, there was no significant difference in prognosis between the two types, but Type B had slower oral intake recovery.