Aim To evaluate the efficacy, safety and feasibility of mediastinoscopy in 107 cases with mediastinal lesions that could not be diagnosed histopathologically with other methods. Methods A total of 107 cases (73 males, 34 females; mean age 57.4, range 30-88 years) with mediastinal lymphadenopathy, who underwent mediastinoscopy between 12 September 2012 and 29 November 2018 were examined retrospectively. The cases were evaluated in terms of age, gender, complaint, operation time, histopathological diagnosis, postoperative morbidity and mortality parameters. Results Upon histopathological examination 32 (30%) patients were diagnosed with lung cancer metastasis (N2 stage), which was the most common diagnosis. With this diagnosis unnecessary thoracotomy was prevented. In patients with pathological lymphadenopathy found by imaging histopathological results were examined to evaluate the presence of N2 stage. In 25 (23.5%) cases biopsy results were reported as reactive lymph nodes. In addition, 23 (21.4%) patients had sarcoidosis, 16 (15%) had tuberculosis lymphadenitis, seven (6.5%) had lymphoma, one of each (0.9%) had benign epithelial cyst (0.9%), malign epithelial tumour (invasive ductal carcinoma of breast), chronic lymphocytic leukaemia (CLL), and adenocarcinoma metastasis (renal cell cancer). Conclusion When other non-invasive procedures are ineffective, mediastinoscopy is an efficient diagnostic method with high diagnostic value, which is applicable also in places other than advanced centres, with low morbidity and mortality.
Carlens E. Mediastinoscopy: a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest. 1959. p. 343–52.
2.
Call S, Obiols C, Rami-Porta R. Present indications of surgical exploration of the mediastinum. J Thorac Dis. 2018. p. 2601–10.
3.
Sehgal I, Dhooria S, Aggarwal A, Behera D, Agarwal R. Endosonography versus mediastinoscopy in mediastinal staging of lung cancer: systematic review and meta-analysis. Ann ThoracSurg. 2016. p. 1747–55.
4.
Ricci C, Rendina E, Venuta F, Pescarmona E, Tolla D, Ruco R, et al. Surgical approach to isolated mediastinal lymphoma. J Thorac Cardiovasc Surg. 1990. p. 691–5.
5.
Chabowski M, Szymanska-Chabowska A, Skotarczak J, Janzcakd, Pawlowski L. The role of mediastinoscopy in the diagnosis of thoracic disease: one-year single center experience. AdvExp Med Biol. 2015. p. 1–4.
6.
Porte H, Roumilhac D, Eraldi L, Cordonnier C, Puech P, Wurtz A. The role of mediastinoscopy in the diagnosis of mediastinal lymphadenopathy. Eur J Cardiothorac Surg. 1998. p. 196–9.
7.
Pattison C, Westaby S, Wetter A, Townsend E. Mediastinoscopy in the investigation of primary mediastinal lymphadenopathy. Scand J Thorac Cardiovasc Surg. 1989. p. 177–9.
8.
Masayoshi I, Katsuhiro N, Kiyohiro F. Results of preoperative mediastinoscopy for small cell lung cancer. Ann Thorac Surg. 2000. p. 1620–3.
9.
Nicholson A, Chansky K, Crowley J, Beyruti R, Kubota K, Turrisi A, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the revision of the clinical and pathologic staging of small cell lung cancer in the forthcoming Eighth Edition of the TNM Classification for lung cancer. J Thorac Oncol. 2016. p. 300–11.
10.
Chauhan A, Kapoor S, Ganguly M, Nath P. Cervical mediastinoscopy: re-evaluation of an old technique in era of new imaging technology. Indian J Chest Dis Allied Sci. 2012. p. 169–73.
11.
Azarow K, Pearl R, Zurcher R, Edwards F. Cohen AJ. Primary mediastinal masses. A comparison of adult and pediatric populations. J Thorac Cardiovasc Surg. 1993. p. 67–72.
12.
Schimmer C, Neukam K, Elert O. Staging of nonsmall cell lung cancer: clinical value of positron emission tomography and mediastinoscopy. Interact Cardiovasc Thorac Surg. 2006. p. 418–23.
13.
Hsu H, Wang L, Hsieh C, Wang C, Wu Y, Huang B, et al. The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. J Chin Med Assoc. 2003. p. 231–5.
14.
Eckardt J, Olsen K, Licht P. Endobronchial ultrasoundguided transbronchial needle aspiration of undiagnosed chest tumors. World J Surg. 2010. p. 1823–7.
15.
Hinterthaner M, Stamatis G. Role of mediastinoscopy and repeat mediastinoscopy today. Chirurg. 2008. p. 40–4.
16.
Jeune L, Baldwin I, D. Measuring the success of transbronchial needle aspiration in everyday clinical practice. Respir Med. 2007. p. 670–5.
17.
Liberman M, Sampalis J, Duranceau A, Thiffault V, Hadjeres R, Ferraro P. Endosonographic mediastinal lymph node staging of lung cancer. Chest. 2014. p. 389–97.
18.
Cata J, Lasala J, Mena G, Mehran J. Anesthetic considerations for mediastinal staging procedures for lung cancer. J Cardiothorac Vasc Anesth. 2018. p. 893–900.
19.
Zakkar M, Hunt I. Complication rates in mediastinoscopy and training: video versus conventional mediastinoscopy. Ann ThoracSurg. 2012. p. 337.
20.
Puhakka H. Complications of mediastinoscopy. J Laryngol Otol. 1989. p. 312–5.
21.
Lemaire A, Nikolic I, Petersen T, Haney J, Toloza E, Harpole D, et al. Nine-year single center experience with cervical mediastinoscopy: complications and false negative rate. Ann Thorac Surg. 2006. p. 1185–9.
22.
Park B, Flores R, Downey R, Bains M, Rusch V. Management of major hemorrhage during mediastinoscopy. J Thorac Cardiovasc Surg. 2003. p. 726–31.
23.
Vansteenkiste J, Stroobants S, De Leyn P, Dupont P, Bogaert J, Maes A, et al. Lymph node staging in non-smallcell lung cancer with FDG-PET scan: a prospective study on 690 lymph node stations from 68 patients. J Clin Oncol. 1998. p. 2142–9.
24.
Wei B, Bryant A, Minnich D, Cerfolio R. The safety and efficacy of mediastinoscopy when performed by general thoracic surgeon. Ann Thorac Surg. 2014. p. 1878–83.
25.
Silvestri G, Gonzalez A, Jantz M, Margolis M, Gould M, Tanoue L, et al. Methods for staging non-small cell lung cancer. Chest. 2013. p. 211–50.
26.
Decaluwé H, Moons J, Fieuws S, Wever D, Deroose W, Stanzi C, et al. Is central lung tumor location really predictive for occult mediastinal nodal disease in (suspected) non-small-cell lung cancer staged cN0 on 18F-fluorodeoxyglucose positron emission tomography-computed tomography? Eur J Cardiothorac Surg. 2018. p. 134–40.
27.
Van Schil P, Lauwers P, Yogeswaran S, Berzenji L, Hendriks J. Surgical management of stage IIIA non-small cell lung cancer. Front Oncol. 2017. p. 249.
28.
Allemani C, Matsuda T, Carlo D, Harewood V, Matz R, Nikšić M, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018. p. 1023–75.
29.
Death Cause Statistics. 26AD.
30.
Castelli F, Tomasoni L. El Hamad I. Migration and chronic noncommunicable diseases: is the paradigm shifting. J Cardiovasc Med. 2014. p. 693–5.
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