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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Marsupialisation of Giant Bronchogenic Cyst through Right Anterior Mini-thoracotomy: A Case Report
Correspondence Address :
Dr. Nembian Raja Rajan,
Assistant Professor, Department of Cardiothoracic and Vascular Surgery, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Nagar, Kattankalathur, Chengalpattu-603203, Tamil Nadu, India.
e-mail: nembianr@srmist.edu.in
Bronchogenic cysts are common mediastinal lesions; however, intrapericardial occurrence is exceedingly rare. The authors report the case of a 50-year-old female who presented with persistent cough and right shoulder pain of three months’ duration. The patient is a known case of systemic hypertension and diabetic type 2 for 5 years and patient was taking medication for the same for 5 years, bronchial asthma, or pulmonary tuberculosis. Clinical examination was unremarkable. Contrast-Enhanced Computed Tomography (CECT) of the chest revealed a large, well-defined intrapericardial cyst causing significant compression of the Left Atrium (LA) and displacement of adjacent mediastinal structures without evidence of invasion. Given the symptomatic presentation and anatomical complexity, surgical management was undertaken. The patient underwent marsupialisation through a minimally invasive right anterior mini-thoracotomy. Intraoperatively, the cyst was found to be densely adherent to surrounding vital structures, including the pulmonary artery and LA, precluding safe complete excision. Approximately, 200 mL of thick mucinous fluid was aspirated, and the cyst wall was opened, everted, and plicated. The postoperative course was uneventful. The patient was extubated early, remained haemodynamically stable, and was discharged on Postoperative Day (POD) 4. Histopathological examination confirmed the diagnosis of a bronchogenic cyst. At the six-month follow-up, the patient remained asymptomatic, with no evidence of recurrence. The present case highlights marsupialisation as a safe and effective alternative in selected complex cases where complete excision carries significant risk.
Cardiac compression, Foregut malformation, Intrapericardial lesion, Surgical drainage technique
A 50-year-old female presented with persistent cough and right shoulder pain for three months, with no associated cardiac or respiratory symptoms. The patient is a known case of systemic hypertension and diabetic type 2 for 5 years and patient was taking medication for the same for 5 years. There was no prior history of coronary artery disease, bronchial asthma, or pulmonary tuberculosis.
Physical examination and laboratory investigations were unremarkable.
Chest radiograph revealed a retrosternal mass. CECT chest showed a well-defined, thin-walled homogeneous cystic lesion in the subcarinal region, involving the middle mediastinum (Table/Fig 1). The cyst caused splaying of the carina, narrowing of the left main bronchus, and compression of the LA, without evidence of infiltration. Echocardiogram confirmed normal biventricular function with left atrial compression (Table/Fig 2).
After induction of anaesthesia with a 35 Fr left-sided double-lumen tube for lung isolation, the patient was positioned in left lateral decubitus. A 6 cm right anterior mini-thoracotomy was made in the 5th intercostal space. The pericardium was opened 2 cm anterior to the right phrenic nerve. The cyst was identified intra-pericardially, encircling the Superior Vena Cava (SVC) and occupying the space between the Right Pulmonary Artery (RPA) and the roof of the LA with dense adhesions (Table/Fig 3). SVC was carefully dissected and looped for retraction. The cyst was punctured, and Approximately, 200 mL of thick whitish mucinous fluid was aspirated. Samples were sent for microbiology and histopathology
Due to dense adhesions and proximity to vital structures, complete excision was not feasible without resorting to cardiopulmonary bypass or deep hypothermic circulatory arrest. Hence, marsupialisation was performed: the cyst wall was widely opened, everted, and plicated with horizontal mattress sutures (2-0 Ethibond with pledgets). The cavity was irrigated with povidone-iodine (Betadine). A 28 Fr pleural drain was placed, and layered closure was completed.
The patient was extubated on table and shifted to Intensive Care Unit (ICU) with stable haemodynamics. The drain was removed on POD 1, and she was discharged home on POD 4. Histopathology with Haematoxylin and Eosin (H&E) stain confirmed the diagnosis of bronchogenic cyst (Table/Fig 4)a-c. At 6-month follow-up, she remained asymptomatic with no recurrence on imaging.
Bronchogenic cysts are congenital anomalies derived from the primitive foregut, representing 10-15% of mediastinal tumours and 50-60% of mediastinal cystic lesions (1). Although most bronchogenic cysts are asymptomatic, they may present with compressive symptoms or complications such as infection, bronchial fistula, pneumothorax, or rarely, malignant transformation (1).
Complete surgical excision is the standard management for most mediastinal bronchogenic cysts and is associated with low recurrence rates and excellent long-term outcomes (2). In recent years, minimally invasive approaches such as Video-Assisted Thoracoscopic Surgery (VATS) and robotic-assisted surgery have gained popularity due to their advantages of reduced postoperative pain, shorter hospital stay, and faster recovery (2),(3). Preoperative differential diagnoses considered were thymoma, thymic hyperplasia, lymphoma, germ cell tumour, retrosternal goiter, and thymic cyst. These were ruled out based on radiological characteristics, intraoperative findings, and histopathological confirmation of a bronchogenic cyst.
In the present case, although a mini-anterior thoracotomy provided excellent exposure, the cyst’s intimate adherence to the pulmonary artery, SVC, and LA rendered total excision unsafe. Therefore, marsupialisation, a rarely reported but viable alternative, was chosen. This technique ensured effective drainage, minimised the risk of recurrence, and avoided injury to vital mediastinal structures. Additionally, the limited incision contributed to reduced postoperative pain and faster recovery.
Several similar cases have been reported in the literature. Martinod E et al., described twenty patients with mediastinal bronchogenic cysts who underwent thoracoscopic surgery. Complete thoracoscopic excision was successfully performed in 13 cases. Conversion to thoracotomy was required in seven cases due to intraoperative bleeding in two patients and dense adhesions to vital structures in five patients (4).
Similar operative difficulties have been reported in a 53-year-old female with a giant bronchogenic cyst causing recurrent respiratory infections and cardiac compression, where thoracoscopic resection required conversion to thoracotomy because of severe pleural adhesions and intraoperative bleeding. Such cases highlight the importance of tailoring the surgical approach according to cyst size, adhesions, and proximity to vital mediastinal structures (5).
Aydin Y et al., documented 13 cases of mediastinal cysts managed via VATS, and observed that proximity to major vessels was a key determinant in the choice of technique; in two patients, complete excision was abandoned in favour of partial resection and drainage due to the risk of vascular injury (6). These reports corroborate our experience and reinforce the role of marsupialisation as a safe and effective alternative when complete excision carries prohibitive risk.
The present case demonstrated that marsupialisation through a minimally invasive anterior thoracotomy is a safe and effective alternative for managing complex intrapericardial bronchogenic cysts when standard excision poses excessive risk. Individualised surgical planning remains critical to achieving optimal outcomes.
The authors wish to acknowledge the writing support of Dr Kavitha Babu, Research Writer, SRM MCH& RC during the preparation of the case report, which helped in preparing the draft.
Authors’ contribution: NRR, SVI are the lead surgeons for the case and performed clinical analysis; SD is the cardiac anaesthesiologist; AA performed all the radio diagnosis. NRR prepared the manuscript. All authors read and approved the final version of the manuscript.
Funding statement: The authors gratefully acknowledge the financial support by SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRMIST, Kattankalathur, Chengalpattu, Tamil Nadu, India, for bearing the defrayed costs of publishing the present article.
DOI: 10.7860/JCDR/2026/86150.24355
Date of Submission: Jan 08, 2026
Date of Peer Review: Mar 10, 2026
Date of Acceptance: May 26, 2026
Date of Publishing: Sep 01, 2026
Author declaration:
• Financial or Other Competing Interests: As declared above
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 03, 2026
• Manual Googling: May 21, 2026
• iThenticate Software: May 23, 2026 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
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