The use of anterior mediastinotomy to assess intrathoracic lesions.
A ten-year experience (1970-1979) with 164 anterior mediastinotomies at a VA hospital to diagnose pulmonary or mediastinal lesions or to assess the resectability of carcinoma of the lung is reported. of 135 attempts to obtain diagnosis, 130 (96%) were successful. Of 19 patients who had a subsequent thoracotomy because the anterior mediastinotomy suggested that a curative resection was possible, 17 (90%) had successful resections. Two (1.7%) patients died-one of a paraneoplastic syndrome and one from progressive respiratory failure. Eleven complications in the 162 survivors included eight minor wound infections, an initially unrecognized pneumothorax, persistent bleeding from a lymph node biopsy site, and an air leak necessitating reoperation in another. Anterior mediastinotomy is a relatively safe procedure, even in patients with advanced carcinoma or lung disease. it has much less risks than a formal thoracotomy and provides much better exposure and diagnostic possibilities than a mediastinoscopy.
D000230:Adenocarcinoma / Q000175:diagnosis; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003949:Diagnostic Techniques, Surgical / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008223:Lymphoma / Q000175:diagnosis; D008479:Mediastinal Neoplasms / Q000175:diagnosis*; D008482:Mediastinum / Q000601:surgery*