Due to recent advances in videotechnology and a worldwide comback of invasive staging methods of the lung cancer, mediastinoscopy has been revived. In the Surgical Clinic of the Faculty Hospital in Plzen, the authors carried out 54 videomagnetoscopic examinations of 53 patients aged 58.1 years on average, in total, during the period from 2000 till 2003. Mostly, in 41 cases (76%) the examination was performed as a part of the lung cancer staging procedure. None of the patients exited in direct correlation with the surgical procedure. Complications, not requiring reoperation, were reported in 2 cases. The lung carcinoma staging findings agreed with the postoperative N disease classification in 86% of the examined cases. Five cases (14%) were underestimated and always the superior lobe carcinomas were concerned, out of which four of them were on the left. At the same time, the non-invasive staging examination using computer tomography (CT) in the mediastinal lung cancer dissemination examination, proved to show a high rate of false-positive findings, when compared to that with videomediastinoscopy. Mediastinoscopy remains the supreme method in determining other pathological affections of the middle mediastinum, if properly indicated. The authors carry out the above miniinvasive examination as a part of the lung cancer staging method in all patients with the CT-confirmed mediastinal lymphonodes enlarged over 1 cm. They consider this method a necessary part of this disease staging protocol, in cases of the left superior lung lobe tumors combined with videothoracoscopy. At the same time the authors recommend it as the method of choice in diagnosing other pathological processes of the middle mediastinum, mainly for its high efficiency rate and its low rates of complications.
Adult Aged