Resumo

MAINIERI-HIDALGO, José A; ARTAVIA-HIDALGO, Ernesto  e  MAINIERI-BREEDY, Marcelo J. Mediastinoscopy: Experience with 140 procedures. Acta méd. costarric [online]. 2014, vol.56, n.3, pp.121-124. ISSN 0001-6002.

Objetive: To determine the sensibility and specificity of mediastinoscopy as a diagnostic and staging procedure for thoracic disease. Method: General information in the database of the Thoracic Surgery Department of the Dr. R.A. Calderón Guardia Hospital on 140 patients that underwent mediastinoscopy between 1989 and 2013 was reviewed. This information was complemented with specific data obtained from clinical records. Results: Mediastinoscopies performed in 140 cases were studied, 94 patients were male and 46 female with a mean age of 55 years. In 136 cases, the samples obtained were adequate for establishing a histological diagnosis, resulting in a sensibility of 97% and in 133 cases this diagnosis was specific for the underlying disease with a specificity of 95%. In all cases involving primary mediastinal lymph node diseases, specificity and sensibility were both 100%. Two patients (1.3%) suffered complications, one involving a lesion of the pulmonary artery and the other of the azygos vein; both were repaired through median sternotomy. There were no cases involving mortality or other complications. Conclusions: The study showed that mediastinoscopy is a useful procedure for diagnosis and staging of thoracic diseases when they involve accessible lymph nodes, which can be determined with a CT scan. Also, it showed that when mediastinoscopy is performed by an experienced surgeon, the percentage of complications is very low.

Palavras-chave : Mediastinoscopy; mediastinal tumors; primary mediastinal lymphoma; sarcoidosis; granulomatous mediastinal disease; thoracic surgery procedures.

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