The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer

Han Shui Hsu, Liang Shun Wang, Chih Cheng Hsieh, Chien Ying Wang, Yu Chung Wu, Biing Shiun Huang, Wen Hu Hsu, Min Hsiung Huang

Research output: Contribution to journalArticle

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Abstract

Background. Mediastinoscopy is a widely used technique in the diagnosis of mediastinal disease and the staging of bronchogenic carcinoma. Its efficacy in the preoperative staging of lung cancer is well-established, with a procedural sensitivity of greater than 90% and specificity of 100%. Mediastinoscopy can also establish the diagnosis in greater than 90% of mediastinal disease. We conducted a retrospective study of mediastinoscopy performed at our institution between 1998 and 2001 to evaluate the safety and efficacy of mediastinoscopy. Methods. We collected 100 consecutive mediastinoscopies performed in Thoracic Division of Taipei Veterans General Hospital between 1998 and 2001. The indications for mediastinoscopy included mediastinal mass or lymphadenopathy and the staging of lung cancer. Some patients had the undetermined lung mass with enlarged mediastinal lymph node. Results. There were 69 men and 31 women aged from 13 to 87 (mean 60.9). Sixty-seven patients had mediastinoscopy for the staging of lung cancer, 29 patients for diagnosis of mediastinal mass or lymphadenopathy, and 4 patients for undetermined lung mass with mediastinal lymphadenopathy. Among the patients with mediastinal disease, sarcoidosis was diagnosed in 13 patients, and lymphoma in 5 patients. N2 or N3 nodal metastasis was revealed in 38 of 67 patients who had lung cancer. Fifteen patients with negative mediastinoscopy proceeded to thoracotomy for tumor resection. Seventeen patients received neoadjuvant chemotherapy followed by resection. There were three complications, all due to bleeding, and no mortality. Conclusions. Mediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer. In cases of lung cancer, mediastinoscopy can provide more accurate evaluation of mediastinal lymph node metastasis than conventional diagnostic tools like computed scan or magnetic resonance image with low morbidity and mortality.

Original languageEnglish
Pages (from-to)231-235
Number of pages5
JournalJournal of the Chinese Medical Association
Volume66
Issue number4
Publication statusPublished - Apr 1 2003
Externally publishedYes

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Thoracic Diseases
Mediastinoscopy
Lung Neoplasms
Mediastinal Diseases
Lymph Nodes
Neoplasm Metastasis
Veterans Hospitals
Lung
Bronchogenic Carcinoma
Mortality
Thoracotomy
Sarcoidosis
General Hospitals
Lymphoma
Magnetic Resonance Spectroscopy
Thorax
Retrospective Studies

Keywords

  • Lung neoplasms
  • Mediastinoscopy
  • Neoadjuvant therapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hsu, H. S., Wang, L. S., Hsieh, C. C., Wang, C. Y., Wu, Y. C., Huang, B. S., ... Huang, M. H. (2003). The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. Journal of the Chinese Medical Association, 66(4), 231-235.

The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. / Hsu, Han Shui; Wang, Liang Shun; Hsieh, Chih Cheng; Wang, Chien Ying; Wu, Yu Chung; Huang, Biing Shiun; Hsu, Wen Hu; Huang, Min Hsiung.

In: Journal of the Chinese Medical Association, Vol. 66, No. 4, 01.04.2003, p. 231-235.

Research output: Contribution to journalArticle

Hsu, HS, Wang, LS, Hsieh, CC, Wang, CY, Wu, YC, Huang, BS, Hsu, WH & Huang, MH 2003, 'The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer', Journal of the Chinese Medical Association, vol. 66, no. 4, pp. 231-235.
Hsu HS, Wang LS, Hsieh CC, Wang CY, Wu YC, Huang BS et al. The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. Journal of the Chinese Medical Association. 2003 Apr 1;66(4):231-235.
Hsu, Han Shui ; Wang, Liang Shun ; Hsieh, Chih Cheng ; Wang, Chien Ying ; Wu, Yu Chung ; Huang, Biing Shiun ; Hsu, Wen Hu ; Huang, Min Hsiung. / The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. In: Journal of the Chinese Medical Association. 2003 ; Vol. 66, No. 4. pp. 231-235.
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abstract = "Background. Mediastinoscopy is a widely used technique in the diagnosis of mediastinal disease and the staging of bronchogenic carcinoma. Its efficacy in the preoperative staging of lung cancer is well-established, with a procedural sensitivity of greater than 90{\%} and specificity of 100{\%}. Mediastinoscopy can also establish the diagnosis in greater than 90{\%} of mediastinal disease. We conducted a retrospective study of mediastinoscopy performed at our institution between 1998 and 2001 to evaluate the safety and efficacy of mediastinoscopy. Methods. We collected 100 consecutive mediastinoscopies performed in Thoracic Division of Taipei Veterans General Hospital between 1998 and 2001. The indications for mediastinoscopy included mediastinal mass or lymphadenopathy and the staging of lung cancer. Some patients had the undetermined lung mass with enlarged mediastinal lymph node. Results. There were 69 men and 31 women aged from 13 to 87 (mean 60.9). Sixty-seven patients had mediastinoscopy for the staging of lung cancer, 29 patients for diagnosis of mediastinal mass or lymphadenopathy, and 4 patients for undetermined lung mass with mediastinal lymphadenopathy. Among the patients with mediastinal disease, sarcoidosis was diagnosed in 13 patients, and lymphoma in 5 patients. N2 or N3 nodal metastasis was revealed in 38 of 67 patients who had lung cancer. Fifteen patients with negative mediastinoscopy proceeded to thoracotomy for tumor resection. Seventeen patients received neoadjuvant chemotherapy followed by resection. There were three complications, all due to bleeding, and no mortality. Conclusions. Mediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer. In cases of lung cancer, mediastinoscopy can provide more accurate evaluation of mediastinal lymph node metastasis than conventional diagnostic tools like computed scan or magnetic resonance image with low morbidity and mortality.",
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AU - Huang, Biing Shiun

AU - Hsu, Wen Hu

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AB - Background. Mediastinoscopy is a widely used technique in the diagnosis of mediastinal disease and the staging of bronchogenic carcinoma. Its efficacy in the preoperative staging of lung cancer is well-established, with a procedural sensitivity of greater than 90% and specificity of 100%. Mediastinoscopy can also establish the diagnosis in greater than 90% of mediastinal disease. We conducted a retrospective study of mediastinoscopy performed at our institution between 1998 and 2001 to evaluate the safety and efficacy of mediastinoscopy. Methods. We collected 100 consecutive mediastinoscopies performed in Thoracic Division of Taipei Veterans General Hospital between 1998 and 2001. The indications for mediastinoscopy included mediastinal mass or lymphadenopathy and the staging of lung cancer. Some patients had the undetermined lung mass with enlarged mediastinal lymph node. Results. There were 69 men and 31 women aged from 13 to 87 (mean 60.9). Sixty-seven patients had mediastinoscopy for the staging of lung cancer, 29 patients for diagnosis of mediastinal mass or lymphadenopathy, and 4 patients for undetermined lung mass with mediastinal lymphadenopathy. Among the patients with mediastinal disease, sarcoidosis was diagnosed in 13 patients, and lymphoma in 5 patients. N2 or N3 nodal metastasis was revealed in 38 of 67 patients who had lung cancer. Fifteen patients with negative mediastinoscopy proceeded to thoracotomy for tumor resection. Seventeen patients received neoadjuvant chemotherapy followed by resection. There were three complications, all due to bleeding, and no mortality. Conclusions. Mediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer. In cases of lung cancer, mediastinoscopy can provide more accurate evaluation of mediastinal lymph node metastasis than conventional diagnostic tools like computed scan or magnetic resonance image with low morbidity and mortality.

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