Abstract

In order to assess the efficacy and safety of mediastinoscopy, we reviewed our nine years experience. We performed 664 mediastinoscopic interventions in 661 patients between 1992 and 2000. Patients were between 14 to 72 years old (mean 47.4 years). Three hundred and seven cases (46%) were operated for lung cancer staging purpose, whereas the other 357 (54%) for the diagnosis of mediastinal pathologies. Extended mediastinoscopy was done in six cases following standard cervical mediastinoscopy for staging purpose. The vena cava superior syndrome was present in 11 of diagnostic mediastinoscopy cases. The most common pathology in the diagnostic group was sarcoidosis in 165 cases, which was followed by tuberculosis in 103 cases. Pathologic result of the biopsies in 20 cases were non-specific lympadenitis and in the other three no pathologic or lymphoid tissue was obtained. Three of these 23 cases underwent re-mediastinoscopy. The final diagnosis was obtained in 334 of 357 cases (diagnostic accuracy 93%). In 59 of 307 patients who had staging mediastinoscopy (19%), metastases to mediastinal lymph nodes were detected and thoracotomy was avoided. Major bleeding in 5 cases (0.7%), recurrent nerve paralysis in 14 cases (2.1%) and pneumothorax in 4 cases (0.6%) were seen. There was no mortality. Mediastinoscopy, with its low morbidity rate and high diagnostic value, is very useful method for either lung cancer staging or diagnosis of other mediastinal pathologies such as tuberculosis, sarcoidosis and lymphoma.