[Value and limits of conventional mediastinoscopy in preoperative evaluation of primary bronchial cancer].
OBJECTIVE
Retrospective evaluation of conventional mediastinoscopy in the preoperative staging of primary lung cancer.


METHODS
Between 1978 and March 1997, 117 consecutive patients underwent conventional mediastinoscopy in the preoperative staging of primary lung cancer, after imaging had shown mediastinal lymph nodes larger than 1.5 cm.


RESULTS
In 8 instances no material was found at mediastinoscopy, in 38 the lymph nodes showed no tumorous infiltration, and in 71 the lymph nodes were metastatic. 48 patients underwent thoracotomy in the same stage, with resection achieved in 41. Contraindications for thoracotomy (in 69) were N2 (45) or N3 (11) disease adn/or small cell lung cancer (18). Mediastinal lymphadenectomy was performed in 26 of the 41 patients who underwent lung resection; half of those with negative nodes at mediastinoscopy had in fact N2 disease, with involvement of 2 areas of more in half. There were no deaths due to mediastinoscopy but 4 complications.


CONCLUSIONS
A favorable mediastinoscopy is not synonymous with resectable disease, nor does it exclude N2 disease; it does however serve to avoid unnecessary thoracotomies in more than half of cases.
Robert
J
J
Uniteé de chirurgie thoracique, Hôpital cantonal universitaire, Genève.
Rochat
T
T
Savioz
D
D
Ludwig
C
C
Spiliopoulos
A
A
D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000473:pathology* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Intérêt et limites de la médiastino-scopie conventionnelle dans le bilan préopératoire du cancer bronchique primitif.