Surgical Experience of Video-Assisted Mediastinoscopy for Nonlung Cancer Diseases
Background Video-assisted mediastinoscopy (VAM) is a valuable method in the investigation of diseases with mediastinal lymphadenopathy or those localized in the mediastinum. The aim of this study was to determine the diagnostic value of VAM in the investigation of mediastinal involvement of nonlung cancer diseases and to describe our institutional surgical experience.
Methods Clinical parameters such as age, sex, histological diagnosis, morbidity, and mortality of all patients who underwent VAM for the investigation of mediastinal involvement of diseases except lung cancer between January 2006 and July 2018 were retrospectively reviewed, and the diagnostic efficacy of VAM was determined statistically.
Results During the study period, 388 patients underwent VAM, and 536 lymph nodes were sampled for histopathological evaluation of mediastinum due to mediastinal lymphadenopathy or paratracheal lesions. The most common diagnoses were sarcoidosis (n = 178 [45.9%]), tuberculous lymphadenitis (n = 108 [27.8%]), lymphadenitis with anthracosis (n = 72 [18.6%]), and lymphoma (n = 15 [3.9%]).
Conclusion The results of the study show that VAM should be used because of its high diagnostic benefit in mediastinal lymphadenopathies, which are difficult to diagnose, or mediastinal lesions located in the paratracheal region. Despite the increase in the number of new diagnostic modalities, VAM is still the most effective method and a gold standard.
Received: 15 February 2020
Accepted: 20 April 2020
07 July 2020 (online)
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Lemaire A, Nikolic I, Petersen T. et al. Nine-year single center experience with cervical mediastinoscopy: complications and false negative rate. Ann Thorac Surg 2006; 82 (04) 1185-1189 , discussion 1189–1190
- 2 Hsu HS, Wang LS, Hsieh CC. et al. The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. J Chin Med Assoc 2003; 66 (04) 231-235
- 3 Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest 1997; 111 (06) 1718-1723
- 4 Anraku M, Miyata R, Compeau C, Shargall Y. Video-assisted mediastinoscopy compared with conventional mediastinoscopy: are we doing better?. Ann Thorac Surg 2010; 89 (05) 1577-1581
- 5 Cho JH, Kim J, Kim K, Choi YS, Kim HK, Shim YM. A comparative analysis of video-assisted mediastinoscopy and conventional mediastinoscopy. Ann Thorac Surg 2011; 92 (03) 1007-1011
- 6 Vyas KS, Davenport DL, Ferraris VA, Saha SP. Mediastinoscopy: trends and practice patterns in the United States. South Med J 2013; 106 (10) 539-544
- 7 Nasir B, Cerfolio RJ, Bryant AS. Endobronchial ultrasound (EBUS) with tranbronchial needle aspiration (TBNA) versus mediastinoscopy for mediastinal staging in non-small cell lung cancer (NSCLC) thoracic cancer. Thorac Cancer 2012; 3 (02) 131-138
- 8 Annema JT, van Meerbeeck JP, Rintoul RC. et al. Mediastinoscopy vs endosonography for mediastinal nodal staging of lung cancer: a randomized trial. JAMA 2010; 304 (20) 2245-2252
- 9 Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer 2009; 45 (08) 1389-1396
- 10 Judson MA. Sarcoidosis: clinical presentation, diagnosis, and approach to treatment. Am J Med Sci 2008; 335 (01) 26-33
- 11 Coker RK. Management strategies for pulmonary sarcoidosis. Ther Clin Risk Manag 2009; 5 (03) 575-584
- 12 Onat S, Ates G, Avcı A. et al. The role of mediastinoscopy in the diagnosis of non-lung cancer diseases. Ther Clin Risk Manag 2017; 13: 939-943
- 13 Burjonrappa SC, Taddeucci R, Arcidi J. Mediastinoscopy in the treatment of mediastinal cysts. JSLS 2005; 9 (02) 142-148
- 14 Granato F, Luzzi L, Voltolini L, Gotti G. Video-assisted mediastinoscopic resection of two bronchogenic cysts: a novel approach. Interact Cardiovasc Thorac Surg 2010; 11 (03) 335-336
- 15 Lesaffer J, Heremans B, De Leyn P, Van Raemdonck D. Video-assisted mediastinoscopic resection of a large symptomatic bronchogenic cyst. Interact Cardiovasc Thorac Surg 2011; 12 (06) 1071-1073
- 16 Ponn BR. Invasive diagnostic procedures. In: Shields TW, LoCicero J, Ponn RB, Rusch VW. eds. General Thoracic Surgery, 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005: 299-313
- 17 Park BJ, Flores R, Downey RJ, Bains MS, Rusch VW. Management of major hemorrhage during mediastinoscopy. J Thorac Cardiovasc Surg 2003; 126 (03) 726-731
- 18 Deeb M. Mediastinoscopy. In: Kaiser LR, Jamieson GG. ed. Operative Thoracic Surgery, 5th ed. London: Edward Arnold Ltd; 2006: 93-97
- 19 Leschber G, Sperling D, Klemm W, Merk J. Does video-mediastinoscopy improve the results of conventional mediastinoscopy?. Eur J Cardiothorac Surg 2008; 33 (02) 289-293
- 20 Yasufuku K, Fujisawa T. Staging and diagnosis of non-small cell lung cancer: invasive modalities. Respirology 2007; 12 (02) 173-183
- 21 Hammoud ZT, Anderson RC, Meyers BF. et al. The current role of mediastinoscopy in the evaluation of thoracic disease. J Thorac Cardiovasc Surg 1999; 118 (05) 894-899