Summary
Report about the results of 2500 mediastinal biopsies by mediastinoscopy, the technical
experience with this method and the rate of complications. In 1552 investigations
done for different reasons it was possible to find characteristic changes in 66% of
the mediastinal specimens. In unknown diseases of mediastinum and/or hilar region
the percentage was higher (88%) than in processes of the lung parenchyma itself (47%).
Especially in sarcoidosis (98%), silicosis (96%) and malignant processes (80%) there
is a remarkable high percentage of positive results.
In 948 routinely examined patients with bronchial carcinoma we found metastases in
34%, more frequently in central position of the tumor (43%) than in the peripheral
one (27%); 20% of the lymph node metastase showed a bi- or contralateral involvement.
In 575 simultaneous biopsies by the Daniels method and mediastinoscopy the mediastinal biopsy was more revealing: 74%:26% in
bronchial carcinoma, 57%:43% in other malignant diseases. Even in diseases with a
high rate of lymph node involvement (Sarcoidosis, silicosis, tuberculosis), the Carlens' biopsy was successful in only 38%. Finally the authors delimit the indications and
results from mediastinoscopy to bronchoscopy, pleuroscopy, small diagnostic thoracotomy,
transbronchial lymph node biopsy by puncture and parasternal hilar biopsy.
Key-Words
Mediastinoscopy - sarcoidosis - silicosis - malignant diseases -
Daniels biopsy - complications
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