[Mediastinoscopy in Iceland: indications and surgical outcome].
Mediastinoscopy is an important tool for staging lung cancer and evaluating mediastinal pathology. The objective of this retrospective study was to investigate the indications and safety of mediastinoscopy in a well defined cohort of patients.



All patients that underwent mediastinoscopy in Iceland between 1983-2007 were included. Clinical information was obtained from patient charts and pathology reports rewied. The study-period was divided into 5-year periods for comparison.



Altogether 278 operations were performed but in 17 cases data was missing, leaving 261 patients for analysis (mean age 59 yrs, range 11-89, 159 males). A steady increase was seen in the number of operations, or from 16 to 85 during the first and last periods, respectively (p<0.01). Staging of lung cancer (61,3%), evaluation of mediastinal tumors (24,5%), and suspected sarcoidosis (8,8%) were the most common indications. Mean operating time was 30 minutes (range 10-320) and median hospital stay 1 day (range 0,5-26). The most common histological diagnosis were nonspecific changes (33,6%), lung cancer (23,8%) and sarcoidosis (12,7%). Seven patients (2.7%) had complications; including 4 (1.5%) with hoarsness due to left recurrent nerve injury, one (0,3%) with pneumothorax and two with >500 ml hemorrhage (1.1%). There were two operative deaths (<30 days), one due to major intraoperative bleeding.



The number of mediastinoscopies is increasing in Iceland, especially as a part of lung cancer staging. Mediastinoscopy is a safe procedure with low mortality and morbidity, where a specific diagnosis is obtained in most cases.
Hjarta- og Lungnaskurodelid, Meinafraeoideild.
Thora Sif
TS
Olafsdottir
Gunnar
G
Gudmundsson
Johannes
J
Bjornsson
Tomas
T
Gudbjartsson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008481:Mediastinoscopy / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012507:Sarcoidosis / Q000175:diagnosis* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult