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Ann Thorac Surg 1992;53:120-122
© 1992 The Society of Thoracic Surgeons

Articles

Repeat mediastinoscopy in the assessment of new and recurrent lung neoplasm

Dirk Meersschaut, MD, Frank Vermassen, MD, Aart Brutel de la Rivière, MD, FCCP*, Paul J. Knaepen, MD, Jules M. Van Den Bosch, MD, Roland Vanderschueren, MD, FCCP

St. Antonius Hospital, Nieuwegein, The Netherlands

Accepted for publication July 24, 1991.

* Address reprint requests to Dr Brutel de la Rivière, St. Antonius Hospital, Postbus 2500, 3430 EM Nieuwegein, The Netherlands.

From 1976 to 1990, 140 patients (mean age, 66 years; 91% male) underwent repeat mediastinoscopy as a routine staging procedure. The mean interval between first and second mediastinoscopy was 56 months. Owing to adhesions, 26 repeat mediastinoscopies (18%) were considered incomplete. There was no mortality, and 10 complications did not require interventional therapy. The results were positive in 20 patients, thus avoiding an unnecessary thoracotomy. In 7 patients with negative findings, positive lymph nodes were found at thoracotomy or by transcarinal puncture biopsy. The sensitivity of repeat mediastinoscopy in this series is 74%, and the accuracy 94%. We consider repeat mediastinoscopy a safe and reliable preoperative staging procedure in new or recurrent lung cancer.




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