Diagnosis of anterior mediastinal mass lesions using the Chamberlain procedure in children.
The mediastinum is the most common site for primary intra-thoracic pathology in childhood. This paper describes the versatility of the Chamberlain operation in establishing tissue diagnosis and guiding definitive treatment in children with mediastinal mass lesions. During 1999-2006, 28 consecutive patients were referred to a National Oncology Center with anterior mediastinal pathology. Eleven underwent the Chamberlain procedure. Demographic data, diagnostic sensitivity, operating time and morbidity were recorded. All patients had preoperative chest X-ray and computed tomography scans. The Chamberlain operation was deployed in only those children without other ways of accurately establishing their diagnosis. Others with mediastinal pathology had a diagnosis established by lymph node biopsy, thoracentesis or other method(s). Eleven patients (nine male, two female; age range 2-13 years) underwent the Chamberlain procedure. In these children, there was no pre-existent diagnosis and this was the primary procedure employed. Diagnostic accuracy was 100%. Three patients had pleural disruption and chest tubes were placed at the time of surgery. No patient required a thoracotomy. Average operating time was 1.3 h. Five patients were diagnosed with Hodgkin's lymphoma, four had non-Hodgkin's lymphoma and two children thymic hyperplasia. The Chamberlain operation provides excellent access to the antero-superior mediastinum for biopsy of obscure mediastinal mass lesions in childhood. Complications from this procedure are very rare.
Department of Surgery, University National Children's Hospital, PO Box 1654-1000, San Jose, Costa Rica. ssalasv@hnn.sa.cr
Sonia
S
Salas Valverde
Yessica
Y
Gamboa
Sergio
S
Vega
Max
M
Barrantes
Mario
M
Gonzalez
Jose Barrantes
JB
Zamora
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000379:methods*