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Technique of Mediastinoscopy

Edward R. Hagopian, MD
Arch Surg. 1974;109(1):116-118. doi:10.1001/archsurg.1974.01360010090022.
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Exploration with biopsy examination of the mediastinum as described by Eric Carlens1 in 1959 has been a valuable addition to thoracic surgery. The technique should be mastered by all surgeons who do thoracic surgery. Mediastinoscopy is a relatively simple and safe procedure. The main value of the procedure is to reduce the number of unnecessary thoracotomies in patients with intrathoracic lesions. Reynders2 in 1964 reported a positive rate of 36.9%. He found that previous to routine use of mediastinoscopy, there was a 40% nonresectable rate of carcinoma of the lung. With negative mediastinoscopy, the resectable rate was increased to 91%.

Mediastinal lymph nodes are almost always involved with granulomas in sarcoidosis. Thus, one can easily make a diagnosis of sarcoidosis through mediastinoscopy according to MacVaugh and Danielson3 in almost 100% of patients with sarcoidosis.

Technique  Mediastinoscopy is best done under endotracheal general anesthesia. The patient is placed


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