Mediastinoscopy. An analysis of 320 consecutive cases

Three hundred and twenty consecutive cases of mediastinoscopy are analysed. Mediastinoscopy is a safe procedure and causes little disturbance to the patient.The preoperative assessment of patients with presumably resectable bronchial carcinoma was the main indication for mediastinoscopy, and its use was associated with a fall in the non-resectability rate at thoracotomy from 28 to 15 per cent over two 3-year periods.The policy of exclusion from exploratory thoracotomy of patients with bronchial carcinoma and mediastinal lymph-node metastases is discussed in relation to the histological nature of the lesion and the site and extent of the mediastinal node involvement.It is concluded that there is a case for offering resection to selected patients with limited mediastinal node invasion from bronchial carcinoma.The value of mediastinoscopy as a diagnostic procedure for mediastinal and pulmonary hilar masses and for undiagnosed pulmonary opacities is shown.