ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Francesco Leo
Nicolas Venissac
Daniel Pop
Jérôme Mouroux
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Leo, F.
Right arrow Articles by Mouroux, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Leo, F.
Right arrow Articles by Mouroux, J.
Related Collections
Right arrow Mediastinum

Ann Thorac Surg 2006;81:1150-1152
© 2006 The Society of Thoracic Surgeons

How to do it

How to Find the Limit Between Station 2 and Station 4 During Mediastinoscopy?

Francesco Leo, MD * , Nicolas Venissac, MD, Daniel Pop, MD, Sabrina Khelef, MD, Jérôme Mouroux, MD

Thoracic Surgery Department, Nice University Hospital, Nice, France

Accepted for publication December 13, 2004.

* Address correspondence to Dr Leo, Thoracic Surgery Department, European Institute of Oncology, Via Ripamonti 435, 20100 Milan, Italy (Email: francesco.leo{at}ieo.it).

During mediastinoscopy, the definition of the limit between station 2 and station 4 is arbitrary. We describe a simple technique based on computed tomographic scan evaluation to precisely define it. The technique is based on calculating the distance between the sternal notch and the upper aortic arch on computed tomographic scan (radiological station 2 lower limit), and subtracting a constant factor (at our institution, 20 mm) to compensate for modifications of mediastinal structures due to neck hyperextension during mediastinoscopy. This corrected distance (surgical station 2 lower limit) is labeled on the mediastinoscope. When the mediastinoscope is inserted to this distance with a lateral deviation of about 45°, the point of contact with the mediastinum of the biopsy forceps is the limit between station 2 and station 4.

We applied this technique in 15 consecutive patients submitted to video-assisted mediastinoscopy for lung cancer. The R2 lower limit was identified by positioning 2 surgical clips during mediastinoscopy. The position of the clips, verified by a chest roentgenogram, was excellent (on the upper aortic arch line) in 7 patients, good (at less than 5 mm from the line) in 6 patients, and acceptable (at 7 mm from the line) in 1 patient. In one case clips were not visible.

The proposed technique is simple and precise. Due to the possible differences in patient positioning during mediastinoscopy in other institutions, this correcting factor (–20 mm) should be verified before using this technique to define the lower limit of station 2.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The Society of Thoracic Surgeons.