Thoracoscopic mediastinal lymph node sampling: Useful for mediastinal lymph node stations inaccessible by cervical mediastinoscopy

R. J. Landreneau, S. R. Hazelrigg, M. J. Mack, L. D. Fitzgibbon, R. D. Dowling, T. E. Acuff, R. J. Keenan, P. F. Ferson

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

Cervical mediastinoscopy is useful for the diagnosis of paratracheal lymph node metastasis from bronchogenic carcinoma. Access to adenopathy in the aorticopulmonary window, anterior mediastinal, periazygos, and subcarinal lymph nodes is difficult with this technique. Operative visibility in these locations through anterior mediastinotomy, the Chamberlain procedure, is limited. We have used thoracoscopic mediastinal exploration in 40 patients with computed tomographic scan evidence of enlarged aorticopulmonary window (n = 30) or enlarged right periazygos or subcarinal lymph nodes (n = 10). This procedure was used primarily as an adjunct to cervical mediastinoscopy in the staging of bronchogenic carcinoma. Adjunctive thoracoscopic nodal sampling was 100% sensitive and 100% specific in diagnosing the mediastinal adenopathy. It did not significantly delay thoracotomy in cases of benign adenopathy. Visibility of the ipsilateral pleural space and mediastinum was excellent. Thoracoscopic exploration with mediastinal nodal sampling is a valuable diagnostic adjunct for assessment of adenopathy inaccessible to cervical mediastinoscopy and can overcome many of the limitations of anterior mediastinotomy.

Original languageEnglish (US)
Pages (from-to)554-558
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume106
Issue number3
DOIs
StatePublished - 1993

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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