Onat Serdar, Ates Gungor, Avcı Alper, Yıldız Tekin, Birak Ali, Akgul Ozmen Cihan, Ulku Refik
Department of Thoracic Surgery, Faculty of Medicine, Dicle University.
Department of Chest Diseases, Memorial Hospital, Diyarbakir.
Ther Clin Risk Manag. 2017 Jul 27;13:939-943. doi: 10.2147/TCRM.S144393. eCollection 2017.
Mediastinoscopy is a good method to evaluate mediastinal lesions. We sought to determine the current role of mediastinoscopy in the investigation of non-lung cancer patients with mediastinal lymphadenopathy.
We retrospectively reviewed clinical parameters (age, gender, histological diagnosis, morbidity, mortality) of all patients without lung cancer who consecutively underwent mediastinoscopy in Hospital of Faculty of Medicine of Dicle University between June 2003 and December 2016.
Two-hundred twenty nine patients without lung cancer who underwent mediastinoscopy for the pathological evaluation of mediastinum during the study period were included. There were 156 female (68%) and 73 male (32%) patients. Mean age was 52.6 years (range, 16 to 85 years). Mean operative time was 41 minutes (range, 25 to 90 minutes). Mean number of biopsies was 9.3 (range, 5 to 24). Totally, 45 patients (19.6%) had previously undergone a nondiagnostic bronchoscopic biopsy such as transbronchial needle aspiration or endobronchial ultrasound-guided transbronchial needle aspiration. Mediastinoscopy was diagnostic for all patients. Diagnosis included sarcoidosis (n=100), tuberculous lymphadenitis (n=66), anthracosis lymphadenitis (n=44), lymphoma (n=11) metastatic carcinoma (n=5), and Castleman's disease (n=1); there was a diagnosis of silicosis in one patient and tymoma in one patient. Neither operative mortality nor major complication developed. The only minor complication was wound infection which was detected in three patients.
Although newer diagnostic modalities are being increasingly used to diagnose mediastinal diseases, mediastinoscopy continues to be a reliable method for the investigation of mediastinal lesions.
纵隔镜检查是评估纵隔病变的一种好方法。我们试图确定纵隔镜检查在非肺癌纵隔淋巴结肿大患者检查中的当前作用。
我们回顾性分析了2003年6月至2016年12月在迪克莱大学医学院医院连续接受纵隔镜检查的所有非肺癌患者的临床参数(年龄、性别、组织学诊断、发病率、死亡率)。
本研究期间,229例非肺癌患者接受了纵隔镜检查以进行纵隔的病理评估。其中女性156例(68%),男性73例(32%)。平均年龄为52.6岁(范围16至85岁)。平均手术时间为41分钟(范围25至90分钟)。平均活检次数为9.3次(范围5至24次)。共有45例患者(19.6%)之前接受过非诊断性支气管镜活检,如经支气管针吸活检或支气管内超声引导下经支气管针吸活检。纵隔镜检查对所有患者均具有诊断价值。诊断包括结节病(n = 100)、结核性淋巴结炎(n = 66)、炭末沉着性淋巴结炎(n = 44)、淋巴瘤(n = 11)、转移性癌(n = 5)和Castleman病(n = 1);1例患者诊断为矽肺,1例患者诊断为胸腺瘤。未发生手术死亡或严重并发症。唯一的轻微并发症是3例患者出现的伤口感染。
尽管越来越多地使用更新的诊断方法来诊断纵隔疾病,但纵隔镜检查仍然是一种可靠的纵隔病变检查方法。