Assessing Surgical Approaches and Postoperative Complications for Thoracic Schwannomas: A Multicenter Retrospective Observational Analysis of 106 Cases

Thoracic schwannomas are benign tumors arising from spinal nerve sheaths with potential neurological and respiratory implications depending on their location. The optimal surgical strategy remains debated, particularly regarding the balance between the extent of resection; complication rates; and postoperative morbidity. This retrospective multicenter study analyzed 106 cases classified according to the Eden system to evaluate surgical outcomes and complications associated with different techniques. Our findings suggest that minimally invasive approaches, such as video-assisted thoracoscopic surgery for extraforaminal lesions and combined neurosurgical–thoracic approaches for dumbbell tumors, improve resection rates while reducing surgical morbidity. Conversely, isolated neurosurgical approaches and open thoracotomy may be associated with increased complication risks. These results support a tailored, multidisciplinary approach based on tumor extension and anatomical constraints to optimize patient outcomes.