[Mediastinoscopy in ambulatory surgery: nine years' experience].
Ambulatory facilities are being used more and more for various diagnostic and therapeutic procedures. We report 183 consecutive mediastinoscopies and/or anterior mediastinotomies performed in an ambulatory setting from July 1981 to January 1991. There were 140 patients with a neoplasia: 131 bronchogenic carcinomas, 5 lymphomas, 2 carcinoid tumors, 1 teratocarcinoma, 1 carcinoma of the stomach. Forty-three patients had a benign condition, including 32 sarcoidosis and 11 miscellaneous diseases. Twenty-eight (15%) patients were admitted the same day: 12 for elective surgery in view of bed availability, 9 for medical observation, and 7 required overnight admission for non-medical reasons. Eight non-fatal complications were encountered: hemoptysis (2), atrial fibrillation (1), pneumonia (1), mediastinal self-contained bleed (1), tear of a pulmonary artery (1), temporary palsy of the recurrent laryngeal nerve (1) and wound infection (1). There was no operative mortality. Overall, ambulatory mediastinoscopy and anterior mediastinotomy permitted a diagnosis in 58 patients (29%), and confirmed unresectable malignant disease in 36 patients, thus sparing unnecessary admission to a surgical ward in 89 (49%) of the 183 patients. Mediastinoscopy and anterior mediastinotomy are safe in an ambulatory setting and alleviate the need for hospitalization in a substantial number of patients.
Vallières
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Département de chirurgie, Université de Montréal, Québec, Canada.
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D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D001982:Bronchial Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001984:Bronchial Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008481:Mediastinoscopy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D011859:Radiography; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000601:surgery
Médiastinoscopie en chirurgie ambulatoire: neuf années d'expérience.