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Experience with mediastinoscopy
  1. T. L. Otto1,
  2. J. Zasłonka,
  3. M. Łukiański
  1. Institute of Tuberculosis and Chest Diseases, Warsaw
  2. Second Surgical Department, Medical Academy. Łódź
  3. Department of Thoracic Surgery, Institute of Postgraduate Studies, Zakopane, Poland

    Abstract

    Six hundred and eighty diagnostic mediastinoscopies are presented. Of these, 552 were classical, 114 anterior mediastinal, 12 posterior mediastinal, and 2 from below the sternum. In addition, 20 therapeutic mediastinoscopies were performed for the insertion of a pacemaker electrode or evacuation of a mediastinal cyst.

    Of 125 mediastinoscopies performed on patients with an initial diagnosis of sarcoidosis, in most the diagnosis was confirmed, the rate of false negative results being 2·4%.

    Extremely encouraging were the results in patients with an initial diagnosis of Hodgkin's disease. Out of 60 patients, a different diagnosis was established in 30 and further follow-up proved this to be correct. In mediastinal tumours the results were discouraging, the rate of false results being as high as 43%.

    Four hundred and ten patients were mediastinoscoped for lung cancer. In 52, mediastinoscopy was the first successful biopsy. Metastases to lymph nodes were found in 139 (33·9%). The percentage of exploratory thoracotomies following the introduction of mediastinoscopy fell from 22% to 14%.

    Mediastinoscopy was also used to investigate the spread of oesophageal cancer and enabled us to exclude patients who were obviously inoperable.

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    Footnotes

    • 1 Reprint requests: T.J.O., ul. Ptocka 26, Warsaw.

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