A Comparative Analysis of Video-Assisted Mediastinoscopy and Conventional Mediastinoscopy

• Published in: The Annals of thoracic surgery Vol. 92; no. 3; pp. 1007 - 1011
• Main Authors: Cho, Jong Ho, MD, Kim, Jhingook, MD, Kim, Kwhanmien, MD, Choi, Yong Soo, MD, Kim, Hong Kwan, MD, Shim, Young Mog, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2011; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biopsy - methods; Bronchoscopy; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - surgery; Cardiology. Vascular system; Cardiothoracic Surgery; Endoscopy; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Mediastinal Neoplasms - diagnosis; Mediastinal Neoplasms - secondary; Mediastinal Neoplasms - surgery; Mediastinoscopy - methods; Medical sciences; Middle Aged; Neoplasm Staging - methods; Pneumology; Pneumonectomy; Reproducibility of Results; Retrospective Studies; Surgery; 13; 10; Analysis; Anesthesia; Endoscopy; Circulatory system; Mediastinoscopy; Cardiology; Comparative study
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2011.02.032

Background The objective of this study was to compare outcomes of video-assisted mediastinoscopic lymph node biopsy in patients with non-small cell lung cancer (NSCLC) with outcomes of conventional mediastinoscopic lymph node biopsy in this same patient population. Methods All mediastinoscopies at one medical center from January 2008 to December 2009 were analyzed. Numbers of lymph nodes dissected, stations biopsied, remnant lymph nodes when major lung resection was performed after mediastinoscopic lymph node biopsy, and complications were recorded. Results Of 521 mediastinoscopies, 222 were in the conventional mediastinoscopic lymph node biopsy group (CM group) and 299 were in the video-assisted mediastinoscopic lymph node biopsy group (VAM group). Eleven complications (2.11%) occurred, with more occurring in the CM group (3.6%) than in the VAM group (1.6%; p = 0.030). The total number of dissected nodes was higher in the VAM group (mean, 8.53 ± 5.8) than in the CM group (mean, 7.13 ± 4.9; p = 0.004), and there was no statistically significant difference between the average number of stations sampled in the CM group (2.98 ± 0.7) and in the VAM group (3.06 ± 0.75; p = not significant). The number of remnant lymph nodes when major lung surgery was performed after mediastinoscopy was lower in the VAM group (mean, 5.05 ± 4.5) than in the CM group (mean, 7.67 ± 6.5; p < 0.001). Conclusions This study found that video-assisted mediastinoscopic lymph node biopsy had fewer complications than did the conventional method. More lymph nodes were examined and fewer lymph nodes remained after mediastinoscopy by video-assisted mediastinoscopy (VAM) than by conventional mediastinoscopy.