Is a third mediastinoscopy really useful?

Abstract

The value of a second remediastinoscopy in the diagnostic assessment ofnew or recurrent lung cancer have never been evaluated before. Weretrospectively reviewed our experience with a third mediastinoscopy in thestaging of lung cancer to define its role. In 13 patients a thirdmediastinoscopy was performed; in all cases the indication was suspected orproven new or recurrent lung cancer. All accessible lymph nodes weresampled. The technical aspects of the procedure are described. Ninepatients with a negative third mediastinoscopy underwent subsequentsurgery, four patients were not operated on, based on the positivehistology and concomitant diseases. There were no major complications.Reremediastinoscopy can be performed safely and has proven to be helpful indefining potential surgical candidates. Mediastinal involvement can beexcluded in most.