Experience with mediastinoscopy

Tl, Otto; Zasłonka, Janusz; Lukiański, M

doi:10.1136/thx.27.4.463

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Such nodes, frequently associated with post-inflammatory adhesions in the interlobar fissures, must be carefully considered before performing Video-Assisted Thoracoscopic Surgery (VATS) or thoracotomy for lymph node biopsy in the absence of parenchymal lesions (32). Cervical mediastinoscopy plays a marginal role in the diagnosis of mediastinal TB since the proportion of patients benefitting from this procedure is considerably limited (33,34). Sayar et al reported a series of 19 patients with no parenchymal abnormalities who underwent mediastinoscopy and TB was confirmed in 16 of them.…”

Section: Diagnosis Of Complicated Casesmentioning

confidence: 99%

“…If bronchoscopic biopsies failed to confirm diagnosis, video-assisted thoracoscopy or mediastinoscopy are valid alternatives. Diagnostic thoracotomy is rarely necessary, but may be considered in selected cases (30,(33)(34)(35)(36)(37)(38). (III) In MDR-TB patients, surgical resection of pulmonary bacillary lesions may be useful to improve treatment outcome if chemotherapy failed, but before complete destruction of lung parenchyma and associated decline in pulmonary function (16,41,44,48,49,99).…”

Section: (Ii)mentioning

confidence: 99%

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Surgery and pleuro-pulmonary tuberculosis: a scientific literature review

et al. 2016

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Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included. The search was focused on five main areas of intervention as follows: (I) diagnosis of complicated cases; (II) elimination of contagious persisting cavities, despite appropriate chemotherapy; (III) treatment of destroyed lung; (V) resection of tuberculomas; (VI) treatment of tuberculous pleural empyema. Although specific practical guidelines concerning surgical indications and approaches are currently unavailable, a summary of the evidence emerged from the scientific literature was elaborated to help the clinician in the management of severely compromised TB patients. The decision to proceed to surgery is usually individualized and a careful assessment of the patient's risk profile is always recommended before performing any procedure in addition to appropriate chemotherapy.

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Section: Diagnosis Of Complicated Casesmentioning

confidence: 99%

Section: (Ii)mentioning

confidence: 99%

Surgery and pleuro-pulmonary tuberculosis: a scientific literature review

et al. 2016

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“…In a combined series of 4,953 patients with primary bronchial carcinoma, positive mediastinal biopsies were obtained in 39% of cases (Jepson and Rahbek, 1970). In more recent series, 2848% of presumably operable patients have yielded positive mediastinal biopsies (Ashraf et al, 1980;Fishman and Bronstein, 1975;Gibbons, 1972;Kirschner, 1971;Larsson, 1976;Otto, Zaslonska and Lukianski, 1972), this proportion representing 80-90%7o (sensitivity) of all patients found to have mediastinal disease at thoracotomy (Jepson and Rahbek, 1970;Larsson, 1976;Pearson, 1968;Pearson et al, 1972). Positive findings, as denoted by the presence ofpathologically identifiable tumour in mediastinal biopsies, provide a highly specific diagnosis and for practical purposes the specificity of mediastinoscopy can be assumed to be 100%.…”

Section: Mediastinoscopy and Mediastinotomymentioning

confidence: 99%

Pre-operative mediastinal evaluation in primary bronchial carcinoma—a review of staging investigations

Elliott

1984

Postgraduate Medical Journal

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Summary A review of staging investigations in the preoperative evaluation of mediastinal involvement in primary bronchial carcinoma is presented. The following conclusions are offered as guidelines for the use of mediastinal staging procedures in clinical practice: Surgical staging methods have the over-riding advantage of superior specificity over indirect imaging techniques. Where 67Ga-imaging or CT scanning are not available, routine pre-operative mediastinoscopy or, when appropriate, mediastinotomy will identify most patients with non-resectable disease but this approach entails a high proportion of true negative examinations. Radioisotope ventilation and perfusion lung imaging has no place in the pre-operative staging of lung cancer. Where the techniques are available, 67Ga-imaging and CT scanning have a use in selecting patients for mediastinal exploration. A negative mediastinal 67Ga scan or a negative CT examination suggest that mediastinal exploration will be unrewarding in the vast majority of cases and may be omitted prior to thoracotomy. A positive mediastinal 67Ga scan or the demonstration of abnormal mediastinal nodes by CT is an indication for mediastinal exploration which, if negative should be followed by thoracotomy.

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