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Ann Thorac Surg 1975;19:121-126
© 1975 The Society of Thoracic Surgeons

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Articles

Mediastinoscopy

Its Application in Central Versus Peripheral Thoracic Lesions

From the Thoracic Surgery Service, Department of Surgery, Wilford Hall USAF Medical Center (AFSC), Lackland AFB, Tex.

Accepted for publication September 24, 1974.

^* Address reprint requests to Dr. Stanford, Thoracic Surgery Service, Wilford Hall USAF Medical Center (AFSC), Lackland AFB, Tex. 78236.

In an attempt to ascertain the value of mediastinoscopy in peripheral lung lesions, records of 157 patients undergoing cervicomediastinal exploration (CME) at Wilford Hall USAF Medical Center were reviewed. Among patients with benign lesions, CME was positive in 90.6% of those who had central lesions and 58.3% of those with peripheral lesions. It was positive in all 7 patients who had peripheral lesions with associated mediastinal nodes on roentgenogram and negative in all 5 who had peripheral lesions without nodes. In the patients with malignant lesions, CME was positive in 72.9% of those who had central lesions and 58.1% of those with peripheral lesions. It was positive in 24 of 27 patients who had peripheral lesions with associated mediastinal nodes and negative in 15 of 16 patients with peripheral lesions without nodes.

Although we recognize this to be a selected series, CME does appear to be valuable in patients with central lesions and peripheral lesions with mediastinal nodal involvement on roentgenogram. It does not appear to be as useful in those with peripheral lesions who do not have central nodal involvement.

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