Elia S, Cecere C, Giampaglia F, Ferrante G
Institute of Thoracic Surgery, 2nd Medical School, University of Naples, Italy.
Eur J Cardiothorac Surg. 1992;6(7):361-5. doi: 10.1016/1010-7940(92)90173-u.
We selected 95 patients with mediastinal adenopathy and no signs of goiter, myasthenia gravis or mediastinal involvement by other disease. All patients underwent, for screening purposes, transthoracic fine needle aspiration biopsy based on chest x-ray and CT findings. Patients were then subdivided into 4 groups. One group of 22 patients with prevalent anterior mass localization underwent anterior mediastinotomy. One group of 19 patients with prevalent middle mediastinal mass localization underwent cervical mediastinoscopy. Two other groups of 27 patients each with both anterior and middle mediastinum localization randomly underwent anterior mediastinotomy or mediastinoscopy. Fifty-one Hodgkin's and 44 non-Hodgkin's lymphomas were diagnosed in total. In 11 cases (11.57%), median sternotomy (2) or thoracotomy (9) were necessary for establishing the final diagnosis. The overall diagnostic accuracy was 80.43% for cervical mediastinoscopy and 95.91% for anterior mediastinotomy. The statistical analysis performed on all patients showed a significant difference (chi 2 = 5.56, P less than 0.025, df = 1) between the two procedures.
我们选取了95例患有纵隔淋巴结肿大且无甲状腺肿、重症肌无力或其他疾病累及纵隔迹象的患者。为进行筛查，所有患者均根据胸部X线和CT检查结果接受了经胸细针穿刺活检。然后将患者分为4组。一组22例以纵隔前部肿块为主的患者接受了前纵隔切开术。一组19例以纵隔中部肿块为主的患者接受了颈部纵隔镜检查。另外两组各27例既有纵隔前部又有纵隔中部肿块的患者随机接受了前纵隔切开术或纵隔镜检查。总共诊断出51例霍奇金淋巴瘤和44例非霍奇金淋巴瘤。在11例（11.57%）患者中，为明确最终诊断需要进行正中胸骨切开术（2例）或开胸手术（9例）。颈部纵隔镜检查的总体诊断准确率为80.43%，前纵隔切开术为95.91%。对所有患者进行的统计分析显示，这两种手术之间存在显著差异（卡方 = 5.56，P < 0.025，自由度 = 1）。
