Mediastinoscopic ultrasonography (MUS)

Hürtgen, Martin; Metzler, Birgit; Friedel, Godehard; Toomes, H.

doi:10.1016/j.ejcts.2004.06.016

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…Of 24 cT4 patients investigated by MUS, 8 were not operated on for oncological or functional reasons. The others underwent R0 resection as predicted [10,11]. The next step was the assessment of other mediastinal staging tools by VAMLA, as we did for 120 patients with negative EUS-FNA findings [16].…”

Section: Resultsmentioning

confidence: 99%

“…Prerequisites for VAMLA and MUS are a two-bladed spreadable videomediastinoscope [4], a sterile finger-tip ultrasound probe [10] (fig. 1), and a dedicated thoracic surgeon familiar with conventional mediastinoscopy and minimally invasive surgery.…”

Section: Methodsmentioning

confidence: 99%

“…For the first time ever, VAMLA facilitates complete mediastinal dissection independent from major surgery. In the same procedure, radiological T overstaging and consecutive undertreatment of central tumors is addressed by intraoperative ultrasound imaging (mediastinoscopic ultrasound; MUS) [10,11].…”

mentioning

confidence: 99%

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New Developments in Videomediastinoscopy: Video-Assisted Mediastinoscopic Lymphadenectomy and Mediastinoscopic Ultrasound

Witte¹

2009

Frontiers of Radiation Therapy and Oncology

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VAMLA is a well-tolerated minimally invasive method for accurate mediastinal staging and radical mediastinal dissection. VAMLA can be carried out independently from tumor resection. We suggest its application together with neoadjuvant strategies, trials, VATS lobectomy, and radiation therapy for curatively intended involved field radiation. Additional MUS is helpful to detect resectable cT4 cases, and offer them curative treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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New Developments in Videomediastinoscopy: Video-Assisted Mediastinoscopic Lymphadenectomy and Mediastinoscopic Ultrasound

Witte¹

2009

Frontiers of Radiation Therapy and Oncology

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“…Damit waren die Voraussetzungen geschaffen für komplexe Prozeduren wie videoassistierte mediastinoskopische Lymphadenektomie (VAMLA) [6], videomediastinoskopische Resektion von Mediastinalzysten [18] oder intraoperativer mediastinoskopischer Ultraschall (MUS) [8]. Analog zur Entwicklung von der Laparoskopie zur minimal-invasiven Abdominalchirurgie und von der Thorakoskopie zur videoassistierten thorakoskopischen Chirurgie (VATS) ist Carlens "method for inspection and tissue biopsie in the superior mediastinum" [1] im Bergriff, sich zur videoassistierten Chirurgie des Mediastinums (VAMS) [28] zu entwickeln, mögli-cherweise mit ähnlichen Perspektiven.…”

Section: Seit 1989 Wurde Auf Anregung Von Toniunclassified

Videoassistierte mediastinoskopische Chirurgie

Witte

Hürtgen

2007

Chirurg

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Introduced in the 1990s, videomediastinoscopes dramatically improved imaging of the mediastinal structures, and made mediastinoscopy more standardized, user-friendly, and accessible to trainees. Not surprisingly they have been replacing conventional mediastinoscopes for routine biopsy and staging procedures. However it was development of the two-bladed spreadable videomediastinoscope by Linder and Dahan that allowed increased exposure, bimanual dissection, and thus the development of new minimally invasive surgical techniques. The best documented method is video-assisted mediastinoscopic lymphadenectomy (VAMLA), which enables extremely accurate staging and definitive mediastinal surgery.

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“…Ultrasound has been used through a mediastinoscope [44] to assess local invasion by central tumours, particularly in the region of the superior vena cava and right pulmonary artery, in which positions air in the trachea limits visualization by transoesophageal echocardiography [45]. …”

Section: Surgical Techniquesmentioning

confidence: 99%

The Future in Diagnosis and Staging of Lung Cancer

Catarino

Goldstraw²

2006

Respiration

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Surgical techniques remain central to the diagnosis and staging of lung cancer. Clinical situations which invoke the role of surgery include the diagnosis of solitary pulmonary masses, staging of the mediastinum, restaging of the mediastinum and the assessment of resectability. The techniques available include cervical mediastinoscopy, anterior mediastinotomy, video-assisted thoracoscopy and different procedures for intra-operative mediastinal lymph node assessment including systematic nodal dissection, lobe-specific nodal dissection and sentinel node mapping. The staging of lung cancer is continuously evolving as technological advances combine with clinical advances to better stratify patients into treatment and prognostic categories and alter pre-operative investigation algorithms. Although most of the surgical techniques have been around for many years, it is their application in future which is likely to change. The increasing use of positron emission tomography/computed tomography fusion imaging is raising the proportion of patients being shown to have additional lesions that could contraindicate surgical treatment but which require tissue confirmation to exclude a false-positive examination. Many such lesions are amenable to the expanding techniques available to the interventional endoscopist. The relationship between the surgeon and the endoscopist must become closer to ensure that the appropriate technique is used at each point in the patient’s pathway. The future of surgical techniques will be driven by: (1) developments in screening and imaging, with a likelihood that more early stage cancers will present and may be amenable to minimally invasive surgical approaches with the possibility of a role for robotics and nanotechnology; (2) improvements in neoadjuvant therapies which will demand flawless mediastinal staging and restaging; (3) advances in molecular biology which, whilst currently requiring that surgery provide samples of tumour and lymph node tissue to fully characterize the disease, do hold the promise that ever smaller amounts of tissue will be required and that eventually the genetic fingerprint will provide a biological ultrastaging to perhaps supersede anatomical staging.

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Mediastinoscopic ultrasonography (MUS)

Cited by 15 publications

References 7 publications

New Developments in Videomediastinoscopy: Video-Assisted Mediastinoscopic Lymphadenectomy and Mediastinoscopic Ultrasound

New Developments in Videomediastinoscopy: Video-Assisted Mediastinoscopic Lymphadenectomy and Mediastinoscopic Ultrasound

Videoassistierte mediastinoskopische Chirurgie

The Future in Diagnosis and Staging of Lung Cancer

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