OUTCOME OF THE DIAGNOSTIC MEDIASTINOSCOPY OF BEGIN TUMOR, MEDIASTINAL MALIGNANT DESEASES AND STAGING OF LUNG CANCER ABSTRACT

Tran Trong Kiem, Nguyen Duc Thang

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Abstract

Background: Mediastinoscopy is a procedure used for the diagnosis of mediastinal disease and the staging of lung cancer. It was introduced by Carlens Since in 1959. Presently, mediastinoscopy has become invasive diagnostic methods very useful. In Vietnam, there is not any research assessment of result of mediastinoscopy in the diagnosis.
Objective: It was the aim of this study to evaluate the results of cervical mediastinoscopy in diagnosing the histological type of mediastinal tumors and staging of lung cancer.
Method: Cross sectional study. 34 patients were confirmed mediastinal tumors or nodes on CT scanner and given a histological diagnose by mediastinoscopy that were performed in 108 Military Centre Hospital in two years (2010-2011)
Results: Group of 34 patients, age from 18 to 77, has average age 51,26. Average of operating time is 32,6 minus. Accident and complication of mediastinoscopy is 01 case that was blooding, no mortality. Maglinant rate of total samples is 10/34 (29,41%), sensitivity of 90% and specificity of 100%. Maglinant mediastinal node are in 7/13 cases of lung cancer (equal N2,N3) and not in 06/13 cases of lung cancer (equal No,N1), more 01 case diagnosed NonHodgkin. Mediastinal benign node without lung caner accounted of 11/12 (91,6%).
Conclusions: Mediastinoscopy is a highly effective and safe procedure. We believe that mediastinoscopy should currently be used routinely in diagnosing the mediastinal tumors and staging of lung cancer.

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References

1. Brion JP, Depauw L, Kuhn G, de Fracquen P, Friberg J, Rocmans, Struyven J(1985). Role of computed tomography and mediastinoscopy in preoperative staging of lung carcinoma. J Comput Assist Tomogr. May-Jun; 9(3):480-4.
2. Henk Kramer, MD and Harry J.M. Groen, MD, PhD (2003). Current Concepts in the Mediastinal Lymph Node Staging of Nonsmall Cell Lung Cancer. Annal of Surgery. August; 238(2): 180–188.
3. Hideki Kimura, MD, PhD, Naomichi Iwai, MD, PhD, Soichiro Ando, MD, PhD, Kimitaka Kakizawa, MD, PhD, Naoyoshi Yamamoto, MD, Hidehisa Hoshino, MD, Takashi Anayama, MD, PhD (2003). A prospective study of indications for mediastinoscopy in lung cancer with CT findings, tumor size, and tumor markers. Ann Thorac Surg;Vol 75: p1734-1739
4. Joseph B. Shrager, MD..The Society of Thoracic Surgeons (2010). Supplement: 2nd International Bi-Annual minimally invasive thoracic surgery summit. Ann Thorac Surg;89:S2084-S2089.
5. Lacquet L.K, Mertens A, Kleef J.V, and Jongerius C. (1975). Mediastinoscopy and bronchial carcinoma: experiences with 600 mediastinoscopies. Thorax. Vol.30, p141-145
6. Lê Nguyễn Quyền, Nguyễn Hoài Nam (2009). Nghiên cứu vai trò nội soi lồng ngực sinh thiết các khối u trung thất. Y học tp Hồ Chí Minh. Vol.13 – No.1, p9-13
7. Luke W.P., Pearson F.G., Todd T.R., Patterson G.A. and Cooper J.D. (1986). Prospective evaluation of mediastinoscopy for assessment of carcinoma of the lung. The Journal of Thoracic and Cardiovascular Surgery, by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association. Vol.91, p53-56
8. Martin D. McCurdy, Peter A. Philip, M.D., Alan T. Marty, M.D., Alfonso M. Miyamoto, M.D.
(1974). Mediastinoscopy: procedure of choice for diagnosis and determination of operability. Cardiovascular diseases, Bulentin of the Texas heart institute. Vol.1, No.3, 1974, p242-250.
9. Mountain C.F, Dresler C.M (1997). Regional lymph node classification for lung cancer staging. Chest 1997; : 1718–1723.
10. P De Leyn, J Vansteenkiste, P Cuypers,G Deneffe, D Van Raemdonck,W Coosemans, J Verschakelen,T Lerut (1997). Role of cervical mediastinoscopy in staging of non-small cell lung cancer without enlarged mediastinal lymph nodes on CT scan. European Journal of CardioThoracic Surgery. Volume 12, Issue 5, November 1997, p706–712
11. Patterson G.A, Ginsberg R.J, Poon P.Y, Cooper J.D, Goldberg M., Jones D., Pearson F.G, Todd
T.R, Waters P. and Bull S (1987). A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma. The Journal of Thoracic and Cardiovascular Surgery, by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association; Vol 94; p679-684
12. Van Schil.PE, Van Hee. RH and Schoofs. EL (1989). The value of mediastinoscopy in preoperative staging of bronchogenic carcinoma.The Journal of Thoracic and Cardiovascular Surgery, by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association. Vol 97, p240-244.
13. Zane T. Hammoud, M.D, Richard C. Anderson, M.D, Bryan F. Meyers, M.D, Tracey J. Guthrie, R.N, BSN, Charles L. Roper, M.D,Joel D. Cooper, M.D, G. Alexander Patterson, M.D (1999). The current role of mediastinoscopy in the evaluation of thoracic disease. J Thorac Cardiovasc Surg;118: p894-899.