Original articleGeneral thoracicNine-Year Single Center Experience With Cervical Mediastinoscopy: Complications and False Negative Rate
Section snippets
Patients and Methods
A retrospective review of a consecutive series of patients undergoing cervical mediastinoscopy between April 1996 and April 2005 was performed with approval and waiver of consent of the Institutional Review Board at Duke University Medical Center. This date range was chosen as it represents the era where dedicated general thoracic surgeons were available. For all patients with suspected lung cancer, mediastinoscopy was routinely performed (unless technically not feasible). Mediastinoscopy was
Results
Between April 1996 and April 2005, 2,145 patients underwent cervical mediastinoscopy for pathology evaluation of the mediastinum. Table 1 summarizes the patient demographics. Of the total patient population, 1,459 (68%) were diagnosed with either nonsmall-cell lung cancer (n = 1,399 or small-cell lung cancer (n = 60). Three hundred and forty-three patients (23.5%) with lung cancer were diagnosed with nodal metastasis to the mediastinum (nonsmall-cell lung cancer = 300, small-cell lung cancer =
Comment
Mediastinoscopy, during this 9-year period, was a safe tool for the diagnosis of mediastinal pathology. Both mortality and morbidity after cervical mediastinoscopy were fortunately uncommon, occurring 0.05% (1 of 2,145) and 1.07% (23 of 2,145) of the time, respectively. The most common complication was vocal cord dysfunction and was not life threatening. Just over half of the patients with new hoarseness required intervention in the form of vocal cord medialization, with the majority of these
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