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. 1975 Apr;30(2):141–145. doi: 10.1136/thx.30.2.141

Mediastinoscopy and bronchial carcinoma: experience with 600 mediastinoscopies.

L K Lacquet, A Mertens, J V Kleef, C Jongerius
PMCID: PMC470258  PMID: 52198

Abstract

Of 600 mediastinoscopies carried out from 1966 to 1973, 479 were performed to assess the operability of a pulmonary carcinoma. Of these, 206 (43%) were positive and 273 (57%) were negative. Of the 161 patients found positive during an initial period, 147 were refused operation; the remaining 14 were considered suitable candidates for operation, either because only one homolateral lymph node site was involved or because there was a concomitant osteoarthropathy. The tumour was irresectable in one of these 14 patients who died after 3-5 months; curative resection was possible in one and palliative resection in 12 patients. These 12 patients all died within a year. Of the 184 patients found negative during an initial period, 149 were treated by operation. The tumour proved irresectable in seven (5%), while curative resection was possible in 113 (76%) and palliative resection in 29 (19%) patients. Comparison with the period 1957-63, when in the same hospital resection was performed after a negative Daniels' (scalene node) biopsy, shows that the tumour was irresectable in 25 (20%) of the 124 patients with a negative biopsy, while curative resection was possible in 43 (35%) and palliative resection in 56 (45%) patients. During a second period, patients with a positive mediastinoscopy were in principle refused operation. Of 89 negative patients, 81 were treated by operation. No tumour was found to be irresectable; curative resection was possible in 63 (78%) and palliative resection in 18 (22%) patients. An operation for bronchial carcinoma was performed on 167 patients between September 1970 and September 1973 after a negative mediastinoscopy in 95, and without mediastinoscopy in 71 patients, either because of a peripheral tumour (70) or because of a tumour relapse after two years (1). The resection was palliative in 11% of the 71 cases, but in only one patient with a peripheral tumour could a mediastinoscopy have been positive. Finally, an operation was performed on one patient with a positive mediastinoscopy and a tumour relapse after six years. A survival study was made of the first 100 patients with pulmonary carcinoma, operated on between September 1970 and March 1972 and with a follow-up from a minumum of two years to a maximum of 3-5 years. The early mortality averaged 10% and was higher after pneumonectomy than after lobectomy. The late mortality was 16% after curative lobectomy, 38% after curative pneumonectomy, and 83% after palliative pneumonectomy. The survival after 2 to 3-5 years was 63%.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carlens E. La médiastinoscopie dans le carcinome bronchogénique. Bronches. 1965 Nov-Dec;15(6):486–491. [PubMed] [Google Scholar]
  2. Freise G., Rensch H. Ergebnisse der Skalenuslymphknotenbiopsie nach Daniels und der Biopsie des oberen vorderen Mediastinums nach Carlens. Thoraxchir Vask Chir. 1967 Apr;15(2):133–141. doi: 10.1055/s-0028-1100609. [DOI] [PubMed] [Google Scholar]
  3. Honore D., Lavigne J., Lejeune G., Desaive C. La médiastinoscopie. Etude clinique de 225 cas. Lyon Chir. 1971 Nov-Dec;67(6):401–404. [PubMed] [Google Scholar]
  4. Hájek M., van der Heide J. N. Early detection of mediastinal spread of pulmonary carcinoma by mediastinoscopy. Thorax. 1970 Nov;25(6):720–724. doi: 10.1136/thx.25.6.720. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. LACQUET L. K., VAN DER SCHAAR P. J. ERVARING MET 275 MEDIASTINOSCOPIEUEN. Acta Chir Belg. 1965 Feb;64:236–241. [PubMed] [Google Scholar]
  6. Labeeu F., Vanderhoeft P. Analyse de 500 médiastinoscopies. Acta Chir Belg. 1970 May;69(5):365–373. [PubMed] [Google Scholar]
  7. Lavigne J., Lejeune G., Desaive C. Valeurs diagnostiques comparées de la biopsie préscalénique et de la médiastinoscopie dans les affections pulmonaires ou médiastinales. Rev Med Liege. 1970 Jan 15;25(2):60–63. [PubMed] [Google Scholar]
  8. Maassen W., Kirsch M., Specht G., Thummler M., von Windheim K. Médiastinoscopie et cancer bronchique. Bronches. 1965 Nov-Dec;15(6):492–515. [PubMed] [Google Scholar]
  9. NOHL H. C. An investigation into the lymphatic and vascular spread of carcinoma of the bronchus. Thorax. 1956 Sep;11(3):172–185. doi: 10.1136/thx.11.3.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. PALVA T., VIKARI S. Mediastinoscopy. J Thorac Cardiovasc Surg. 1961 Aug;42:206–212. [PubMed] [Google Scholar]
  11. PEARSON F. G. MEDIASTINOSCOPY: A METHOD OF BIOPSY IN THE SUPERIOR MEDIASTINUM. J Thorac Cardiovasc Surg. 1965 Jan;49:11–21. [PubMed] [Google Scholar]
  12. REYNDERS H. MEDIASTINOSCOPY IN BRONCHOGENIC CANCER. Dis Chest. 1964 Jun;45:606–611. doi: 10.1378/chest.45.6.606. [DOI] [PubMed] [Google Scholar]
  13. VAN DER SCHAAR P. J., VAN ZANTEN M. EXPERIENCE WITH MEDIASTINOSCOPY. Thorax. 1965 May;20:211–213. doi: 10.1136/thx.20.3.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. VANDENBERGH O., DIERICKX R., BUYSSENS N. OVER DE PRESCALENISCHE BIOPSIE VOLGENS DANIELS. Acta Tuberc Pneumol Belg. 1964 Jul-Aug;55:298–308. [PubMed] [Google Scholar]
  15. van der Schaar P. J., Lacquet L. K. Notre expérience de la médiastinoscopie. Ann Chir Thorac Cardiovasc. 1965 Oct;4(4):538–540. [PubMed] [Google Scholar]

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