Mediastinoscopy

Last updated
Mediastinoscopy
ICD-9-CM 34.22
MeSH D008481
OPS-301 code 1-691.1

Mediastinoscopy is a procedure that enables visualization of the contents of the mediastinum, usually for the purpose of obtaining a biopsy. [1] Mediastinoscopy is often used for staging of lymph nodes of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma.[ citation needed ]

Contents

Mediastinoscopy involves making an incision approximately 1 cm above the suprasternal notch of the sternum, or breast bone. Dissection is carried out down to the pretracheal space and down to the carina. A scope (mediastinoscope) is then advanced into the created tunnel which provides a view of the mediastinum. The scope may provide direct visualization or may be attached to a video monitor.[ citation needed ]

Mediastinoscopy provides access to mediastinal lymph node levels 2, 4, and 7.[ citation needed ]

Current Use

Historically, mediastinoscopy has been the gold standard for the staging of lung cancer. However, with advances in minimally invasive procedures and imaging, mediastinoscopy usage has declined significantly from 2006 to 2010. [2]

Extended mediastinoscopy

Extended mediastinoscopy is a technique which allows access to the pre-aortic (station 6) and aortopulmonary window (station 5) lymph nodes.[ citation needed ]

Parasternal mediastinotomy

Parasternal mediastinotomy, aka, a Chamberlain procedure, is the standard approach to access lymph nodes at stations 5 and 6.[ citation needed ]

References

  1. Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 18531854. ISBN   0-07-145739-9.
  2. Vyas, Krishna S.; Davenport, Daniel L.; Ferraris, Victor A.; Saha, Sibu P. (2013). "Mediastinoscopy". Southern Medical Journal. 106 (10): 539–44. doi:10.1097/SMJ.0000000000000000. PMC   4387790 Freely accessible. PMID   24096946.