title: The incidence of hoarseness after mediastinoscopy and outcome of video-assisted versus conventional mediastinoscopy in lung cancer staging.
abstract: Objectives Theoretically, video-assisted mediastinoscopy (VM) should provide a decrease in the incidence of hoarseness in comparison with conventional mediastinoscopy (CM). Methods An investigation of 448 patients with the NSCLC who underwent mediastinoscopy (n = 261 VM, n = 187 CM) between 2006 and 2010. Results With VM, the mean number of sampled LNs and of stations per case were both significantly higher (n = 7.91 ± 1.97 and n = 4.29 ± 0.81) than they were for CM (n = 6.65 ± 1.79 and n = 4.14 ± 0.84) (p < 0.001 and p = 0.06). Hoarseness was reported in 24 patients (5.4%) with VM procedures resulting in a higher incidence of hoarseness than did CM procedures (6.9% and 3.2%) (p = 0.08). The incidence of hoarseness was observed to be more frequent in patients with left-lung carcinoma who had undergone a mediastinoscopy (p = 0.03). Hoarseness developed in 6% of the patients sampled at station 4L, whereas this ratio was 0% in patients who were not sampled at 4L (p = 0.07). A multivariate analysis showed that the presence of a tumor in the left lung is the only independent risk factor indicating hoarseness (p = 0.09). The sensitivity, NPV, and accuracy of VM were calculated as to be 0.87, 0.95, and 0.96, respectively. The same staging values for CM were 0.83, 0.94, and 0.95, respectively. Conclusion VM, the presence of a tumor in the left-lung, and 4L sampling via mediastinoscopy are risk factors for subsequent hoarseness. Probably due to a wider area of dissection, VM can lead to more frequent hoarseness.
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Sayar
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Çitak
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Songül
authors.initials: S
authors.lastname: Büyükkale
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Metin
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Kök
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Çelikten
authors.affiliation: a Yedikule Thoracic Surgery and Chest Disease Research and Education Hospital , İstanbul , Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Gürses
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006685:Hoarseness / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008481:Mediastinoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000009:adverse effects* / Q000379:methods
keywords: Complications; hoarseness; lung cancer; mediastinoscopy; staging