Repeat mediastinoscopy.
Although it has been maintained that a repeat mediastinoscopy results in high morbidity and mortality, it was considered an essential staging procedure in this group of 12 patients. The results of repeat mediastinoscopy were negative in 10 patients and positive in 2. On the basis of negative findings, 6 patients underwent thoracotomy. Five of them had a possible curative resection, and the remaining patient had an unresectable invasive carcinoma. An unnecessary thoracotomy was avoided in 2 patients with positive mediastinal nodes. For various reasons, thoracotomy was not indicated in the other 4 patients. In the evaluation of a patient with a new or recurrent pulmonary lesion, repeat mediastinoscopy can be performed safely. When findings are negative, it would appear to increase the likelihood of a curative resection, whereas when findings are positive, an unnecessary thoracotomy can be avoided.
D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008481:Mediastinoscopy / Q000009:adverse effects; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D012086:Reoperation