Videomediastinoscopy: a Ten Year Experience on Lung Cancer Stadiation and Non-Diagnosed Mediastinal Lymphoadenopathy

Cervical Mediastinoscopy (CM) is a surgical procedure in it’sown right requiring an operating room and general anesthesiaand, in the recent past, the absence of minimally invasivetechniques had created the myth of mediastinoscopy as the"gold standard" for the pathological staging of the mediastinum.Nowadays, investigating the mediastinum is differentand this calls for a review of the role of the "gold standard”CM. Between January 1999 and December 2012 a total of 303CM were performed; 167 for pre-operative lung cancer stadiationand 136 for non-diagnosed enlargement of mediastinalnodes. The nodal stations investigated where those usuallyobtainable with CM. Out of 167 CM for lung cancerstadiation, 102 were positive for metastatic nodal disease, 65were negative. Out of 136 VAMs performed for other reason(indications other than lung cancer) 15 were diagnostic forlymphoma (NLH LH 2 4), 8 revealed non metastatic lungdisease, 55 were suggestive for sarcoidosis, 10 for tubercularadenitis and 48 for non-specific adenitis. The data presentedin this paper refer to the activity of a single institution in theperiod between 1999 and 2012 and the results we haveextrapolated correspond with our idea that, despite theprogress of new methods, we cannot as yet, do withoutmediastinoscopy.

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