Clinical application of mediastinoscopy in the diagnosis of thoracic disease

Purpose To evaluate clinical application of mediastinoscopy in the diagnosis of thoracic disease. Methods Ninety-four cases with mediastinal lymphadenopathy or mass who were undergone biopsy and resection by standard cervical mediastinoscopy(SCM) from May,2002 to March,2005 in our division were retrospectively reviewed. Results Among 94 cases,79 cases who were preoperatively diagnosed with unknown mediastinal mass or lymphadenopathy by chest Computer tomography(CT) did not obtain the pathological cell by bronchoscopy,sputum cytology or percutaneous pneumocentesis biopsy,by SCM,74 cases obtained the pathological diagnosis,while the other 5 cases did not obtain the pathological diagnosis.Other 15 cases diagnosed of lung cancer with N2 or N3 mediastinal lymphadenopathy,SCM found 8 cases with tumor metastasis and the patients were given up surgical resection.Seven cases with negative pathological finding by SCM were followed by thoracotomy,except for 1 unresected case.Postoperative pathology of mediastinal lymph nodes sampling confirmed 5 SCM findings,1 patients with SCM negative results were found metastasis.No severe complications happened except for 1 bleeding need surgical intervention in this group. Conclusions SCM is valuable in the diagnosis of unknown mediastinal mass or lymphadenopathy and provides the pathological diagnosis for suspicious N2 or N3 lymphdenopathy of lung cancer.