Abstract: Objective:The experience of treating giant mediastinal tumor was summarized.Method:A total of 31 patients received radical surgery.The surgical rout was based on the location and growth direction of the tumor，while the surgical mode depended on the involved tissues surrounding the tumor.Three Tshape incisions，5 Hemiclamshell incisions and 23 posterolateral incisions were performed.The parameters associated with perioperative managements were analyzed.Result:14 malignancies and 17 benign tumors were included.The average age was younger for patients with malignancies than benign tumors（P<0.05）.The average volume was larger for patients with malignancies than benign tumors（P<0.05）.The durations of surgery，drainage and stay in hospital were longer for malignancies（P<0.05）.The bleeding was much more for malignancies（P<0.05）.Extended tumorectomy were always made for malignancies.Piecemeal resection was suitable for gigantic tumors within superior mediastinum（especially for malignancies）.All the malignancies received adjuvant chemotherapy after surgery and achieved good prognosis.Conclusion:Surgery was recommended for giant mediastinal tumors.It was sufficient evaluation before surgery and rational surgical strategy that achieved better prognosis.The selectivity of surgical rout and mode was the key to success.

Key words: mediastinal tumor, surgery, prognosis, malignancy