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Ann Thorac Surg 2002;74:1720-1723
© 2002 The Society of Thoracic Surgeons

How to do it

Biopsy of anterior mediastinal masses under local anesthesia

Erino A. Rendina, MDa*, Federico Venuta, MDa, Tiziano De Giacomo, MDa, Anna Maria Ciccone, MDa, Marco S. Moretti, MDa, Mohsen Ibrahim, MDa, G. Furio Coloni, MDa

a Division of Thoracic Surgery, Department of Surgery "Paride Stefanini," University of Rome "La Sapienza," Rome, Italy

* Address reprint requests to Dr Rendina, Division of Thoracic Surgery, Department of Surgery "Paride Stefanini," University "La Sapienza," Roma, Policlinico Umberto I, 00161 Rome, Italy
e-mail: erinoangelo.rendina{at}tin.it

Presented at the Thirty-eighth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2002.

Treatment of most primary mediastinal tumors is based on positive histological diagnosis; we describe a variation of anterior mediastinoscopy under local anesthesia. After infiltration with local anesthetic, a transverse skin incision is made in the second, third, or fourth interspace. The endothoracic fascia is incised vertically adjacent to the periosteum and a mediastinoscope is inserted in the mediastinum. Between 1995 and 2001, we have employed this technique in 46 patients with anterior mediastinal tumors. Histological diagnosis was obtained in all patients. Pneumothorax (2 patients) was drained by a tube removed at the end of the procedures. No other complications occurred and all patients were discharged from hospital within 24 hours. Mediastinoscopy under local anesthesia proved safe and effective for diagnosing anterior mediastinal tumors.




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