Marty-Ané C, Pezet D, Camilleri L, Escande G, Mercier R
Rev Pneumol Clin. 1985;41(4):283-93.
Mediastinoscopy is an invasive technique used to explore the anterior and upper mediastinum. The axial mediastinum and its lymph nodes are explored through the cervical approach, and the pulmonary vessels and anterior mediastinal lymph nodes through the parasternal approach. Bronchial carcinomas which extend to the mediastinum, either via the lymphatic system or by contiguity, are of extremely severe prognosis. The advent of mediastinoscopy has considerably reduced the number of exploratory thoracotomies and therefore the operative mortality rate, while increasing the resectability rate to 95%. It has also narrowed the indications for surgery without decreasing the number of curative resections. In the hands of experienced operators, the technique has a low morbidity rate. CT examination is not as accurate as mediastinoscopy to evaluate the mediastinal extension of bronchial carcinomas, but it can help to lay down the indications for the invasive technique, thereby limiting its use to selected cases.
纵隔镜检查是一种用于探查前纵隔和上纵隔的侵入性技术。通过颈部入路探查轴位纵隔及其淋巴结，通过胸骨旁入路探查肺血管和前纵隔淋巴结。通过淋巴系统或直接蔓延至纵隔的支气管癌预后极差。纵隔镜检查的出现显著减少了探查性开胸手术的数量，从而降低了手术死亡率，同时将可切除率提高到95%。它还在不减少根治性切除数量的情况下缩小了手术适应症范围。在经验丰富的操作者手中，该技术的发病率较低。CT检查在评估支气管癌纵隔侵犯方面不如纵隔镜检查准确，但它有助于确定侵入性技术的适应症，从而将其应用限制在特定病例中。
