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Video-assisted cervical mediastinoscopy: our seven-year experience

^a Department of Thoracic Surgery, ‘G. Hatzikosta’ General Hospital of Ioannina, Ioannina, Greece
^b Department of Surgery, ‘G. Hatzikosta’ General Hospital of Ioannina, Ioannina, Greece
^c Department of Cardio–Thoracic Surgery, University Hospital of Ioannina, Ioannina, Greece

Corresponding author. 11, Kiouptsidou, GR-55133, Thessaloniki, Greece. Tel.: +30-2310-451214; fax: +30-2310-451214.

E-mail address: hkarfis{at}yahoo.gr (E.A. Karfis).

Mediastinal exploration is a common procedure used for the diagnosis of the thoracic diseases and the staging of lung cancer. A retrospective review was performed to assess sensitivity, specificity, accuracy and morbidity of video-assisted cervical mediastinoscopy (VACM). From 1999 to 2006 a total of 139 VACMs were performed in 138 patients. Eighty-seven patients were evaluated for known or suspected lung cancer (CN2 or CT scan) – group 1. Fifty-one patients underwent VACM for the evaluation of adenopathies or masses having no indication of lung cancer – group 2. In group 1, the diagnosis of lymph node (LN) involvement was certified in 55 patients – sensitivity 80.8%. The remaining 27 patients (28.7%) were negative and underwent thoracotomy. In group 2, we obtained a definitive diagnosis in 57 patients – sensitivity 93.6%. In the negative patients the definitive histological diagnosis was obtained by means of thoracotomy or other procedure. The more frequent pathologies were lymphomas in 15 patients, sarcoidosis in 13 and reactive lymphadenitis in 14 patients. The mean operative time was 41.7 min. Mean number of sampled nodal stations was 1.9. There were two patients with complications (1.4%). The mortality rate was 0%.

Key Words: Mediastinoscopy; Lung cancer diagnosis and staging; Mediastinal lymph nodes; Video-assisted thoracic surgery