The cervical mediastinoscopy, developed by Carlens in 1959 is used primarily to evaluate, before thoracotomy, the status of mediastinal limph nodes in patients with lung cancer. However, exploration of the anterior mediastinum by these techniques can also identify other diseases processes such as sarcoidosis, tuberculosis, mycotic granulomatous infections and neoplastic diseases involving the mediastinum such as lymphoma. ln this study we analyze the medical reports of 125 patients in which mediastinoscopy was performed for the diagnosis of intrathoracic diseases. The procedure was performed with general anesthesia and orotracheal intubation in all patients out in two, submitted to mediastinoscopy with local anesthesia. The surgical approaches used were: cervical (n=103). anterior (n=7) and cervical + anterior (n=15). There were 80 male and 45 female patients. The age ranged from 13 to 75 years. Carcinoma was the most prevalent diagnosis obtained (36.8%), followed by lymphoma (16%) and sarcoidosis (14.4%). In nine patients the exam was inconclusive, being responsible for a 7.2% failure index of the method. In eleven patients presenting superior vena cava syndrome, mediastinoscopy was performed without aditional complications, except in one case in which symptoms worsenned. We conclude that mediastinoscopy is a safe procedure and it is a valuable tool for the diagnosis of paratracheal mediastinal masses and lymphadenomegalies.
Mediastinoscopy; Lung cancer; Mediastinum