Abstract

FUENTES VALDES, Edelberto. Anterior mediastinotomy and cervical mediastinoscopy in the diagnosis of mediastinal tumoral lesions. Rev Cubana Cir [online]. 2005, vol.44, n.1, pp. 0-0. ISSN 1561-2945.

In order to establish the histological diagnosis and the treatment to be applied in the mediastinal tumors, the surgical access is frequently needed. Objective: to determine the value of the cervical mediastinoscopy and the anterior mediastinotomy in the diagnosis of tumoral lesions of the mediastinum. Methods: 32 patients with expansive mediastinal lesions who underwent a mediastinal exploration to obtain tissular sample for biopsy and were treated from January 2002 to June 2004, were presented. The procedure was considered useful when the sample was enough for the histological study. Results: 38 explorations of the mediastinum were carried out with diagnostic ends. An absolute predominance of lymphomas (75 %) was found. In 26 patients (81.2 %) the diagnosis was obtained during the first exploration, whereas in 6 (18.8 %), it was necessary to conduct a second exploration that in 3 cases consisted in a second anterior mediastinotomy, as well as a mean sternotomy , new cervical mediastinoscopy and video-assisted thoracoscopy to have a diagnosis in 100 % of the cases. A lesion of the internal mammary vein was produced in 3 occasions and pneumothorax in one. The superficial sepsis of the wound was the postoperative complication observed in 2 cases. There were no deaths related to the procedure. Conclusions: the mediastinal exploration (cervical mediastinoscopy and anterior mediastionotomy) is effective when it is necessary to establish with a minimum morbidity and without mortality, the histological diagnosis of mediastinal expansive lesions, mainly before the suspicion of lymphoma

Keywords : Mediastinum; cervical mediastinoscopy; anterior mediastinotomy.

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