Mediastinoscopy invasive examination of the mediastinum, which is performed in a hospital setting, under general anesthesia. The indication for its implementation is, inter alia, lung cancer. Mediastinoscopy allows for the taking of tissue specimens for histopathological examination and assessment of the stage of the neoplasm. What are the other indications for mediastinoscopy? What is this examination about? What are the most common complications?

Mediastinoscopytomediastinoscopyusing an optical device called a mediastinoscope. Mediastinoscopy is an invasive test that is performed in a hospital setting under general anesthesia.

Mediastinoscopy - indications for the examination

Mediastinoscopy is performed when the current test results (e.g. chest X-ray) indicate a disease in the chest area and you need to get to know it in more detail. This mainly applies to cancers of the thoracic region, especially lung cancer. This allows you to determine if the patient needs to be operated on, or if he or she can receive chemotherapy or radiotherapy first. In addition, mediastinoscopy enables the evaluation of the mediastinum in the case of suspected tumor infiltration of the trachea or large vessels.

The main indication for the examination is enlargement of the mediastinal lymph nodes, which may indicate various diseases.

The indications for the test are also:

  • other lung diseases
  • diseases of the lymphatic system (e.g. malignant neoplasms of the lymph nodes - Hodgkin's disease, etc.)
  • sarcoidosis

Mediastinoscopy cannot be performed in patients with ascending aortic or aortic arch dissecting aneurysm, superior vein syndrome, prior mediastinal irradiation, coagulopathies, and cervical spine diseases.

Mediastinoscopy - how to prepare for the examination?

You should go to the test on an empty stomach.

Mediastinoscopy - what is it?

The examination takes place in the operating room under general anesthesia. The doctor makes a small, 3-5 cm long, transverse cut in the patient's neck, just above the breastbone. Then he cuts and lifts the pre-tracheal fascia with his finger and dissects the median spacemediastinum. Only then does a mediastinoscope (a rigid metal tube equipped with appropriate lenses) with a light source inserted between the trachea and the sternum into the mediastinum.

While viewing the mediastinum, the lymph nodes or a part of them are also collected for histopathological or bacteriological evaluation with the use of appropriate instruments inserted through the speculum. After the endoscopy is completed, he puts sutures and a sterile dressing in the place of the incision. The test usually takes 30 - 45 minutes.

After the procedure, the patient may have difficulty swallowing, hoarseness and coughing, but these symptoms disappear quickly.

Mediastinoscopy - recommendations after the test

After the examination, the patient is transported in a wheelchair to the hospital ward, where he should lie down for at least several hours. Usually, it is not until the next day after the examination that she can get up. About 7-10 days after the examination, a doctor comes to the doctor who will remove the stitches.

Mediastinoscopy - possible complications

Complications are not common but always serious and occur in 2% of cases. The most common are:

  • bleeding from a larger vessel
  • vocal cord paralysis
  • pneumothorax
  • mediastinitis

The risk of death is low and amounts to less than 1 percent.

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