HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael Thermann Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Thermann, M. Articles by Schröder, D. Search for Related Content PubMed PubMed Citation Articles by Thermann, M. Articles by Schröder, D.

Ann Thorac Surg 1984;37:443-447
© 1984 The Society of Thoracic Surgeons

---

Articles

Evaluation of Tomography and Mediastinoscopy for the Detection of Mediastinal Lymph Node Metastases

From the Abteilung Allgemeine Chirurgie, Radiologie, and Pathologie, Universität Kiel, West Germany

Accepted for publication October 12, 1983.

^* Address reprint requests to Prof. Dr. Thermann, Abteilung Allgemeine Chirurgie, Chirurgische Universitäts–Klinik Kiel, Hospitalstr 40, D 2300 Kiel-1, West Germany

In a prospective study of 88 patients seen consecutively with proven or suspected bronchial carcinoma, the validity of x-ray tomography and routine mediastinoscopy was tested for the detection and evaluation of mediastinal lymph node metastases. Postive mediastinum was defined as malignant tissue found in the mediastinum and negative mediastinum as mediastinoscopy with negative results plus a negative intraoperative mediastinal lymph node dissection. Thirty-four patients were eliminated from the analysis because carcinoma was not found or because mediastinal evaluation was incomplete by these criteria. Twenty-eight of the remaining 54 patients had mediastinal metastases.

Sensitivity was 67% for tomography and 79% for mediastinoscopy. Specificity was 92% for tomography and 100% for mediastinoscopy. The differences were not significant. Sixty-six of 85 mediastinoscopies were unnecessary or unhelpful in the decision to exclude a patient from surgical intervention. Among 19 patients with lesions presumed to be inoperable based on results of mediastinoscopy (i.e., perinodal metastatic growth suspected by palpation or histologically proven), 14 patients had positive tomographic scans and 1 could not be evaluated radiographically because of right upper lobe atelectasis. We conclude that tomography of the upper mediastinum should be used to select patients for mediastinoscopy.

This article has been cited by other articles:

				N. Venissac, M. Alifano, and J. Mouroux Video-assisted mediastinoscopy: experience from 240 consecutive cases Ann. Thorac. Surg., July 1, 2003; 76(1): 208 - 212. [Abstract] [Full Text] [PDF]

				M. Thermann Reply Ann. Thorac. Surg., July 1, 1990; 50(1): 163 - 163. [PDF]

				D. B. Skinner Technical and scientific advances in general thoracic surgery Ann. Thorac. Surg., January 1, 1990; 49(1): 14 - 25. [PDF]

				D. J. Malenka, G. L. Colice, C. Jacobs, and J. R. Beck Mediastinal Staging in Non-small-cell Lung Cancer Med Decis Making, December 1, 1989; 9(4): 231 - 242. [Abstract] [PDF]

				M. Thermann, R. Bluemm, U. Schroeder, E. Wassmuth, and R. Dohmann Efficacy and Benefit of Mediastinal Computed Tomography as a Selection Method for Mediastinoscopy Ann. Thorac. Surg., October 1, 1989; 48(4): 565 - 567. [Abstract] [PDF]

				M. Coughlin, J. Deslauriers, M. Beaulieu, B. Fournier, M. Piraux, J. Rouleau, and A. Tardif Role of Mediastinoscopy in Pretreatment Staging of Patients with Primary Lung Cancer Ann. Thorac. Surg., December 1, 1985; 40(6): 556 - 560. [Abstract] [PDF]

				W. G. Graves, M. J. Martinez, P. L. Carter, M. J. Barry, and J. S. Clarke The Value of Computed Tomography in Staging Bronchogenic Carcinoma: A Changing Role for Mediastinoscopy Ann. Thorac. Surg., July 1, 1985; 40(1): 57 - 59. [Abstract] [PDF]