Extended Cervical Mediastinoscopy

  • Sergi CallEmail author
  • Carme Obiols
  • Ramon Rami-Porta


Surgical exploration of subaortic and para-aortic lymph nodes has traditionally required the combination of standard cervical mediastinoscopy and left anterior mediastinotomy (Chamberlain’s procedure). Video-assisted thoracoscopic surgery is another technique that allows the exploration of these nodal stations. Extended cervical mediastinoscopy, for which the mediastinoscope is passed over the aortic arch between the innominate artery and the left carotid artery through the same incision of the standard cervical mediastinoscopy, is a useful and safe technique for the assessment of para-aortic and subaortic nodal stations. This procedure is also a useful tool to explore and biopsy anterior mediastinal masses, especially when other diagnostic techniques have not been effective.


Aortic Arch Bronchogenic Carcinoma Innominate Artery Anterior Mediastinum Anterior Mediastinal Mass 
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  1. 1.
    Carlens E. Mediastinoscopy: a method of inspection and palpation in the superior mediastinum. Dis Chest. 1959;36:343–52.PubMedCrossRefGoogle Scholar
  2. 2.
    Pearson FG, Nelems JM, Henderson RD, et al. The role of mediastinoscopy in the selection of treatment for bronchial carcinoma with involvement of superior mediastinal nodes. J Thorac Cardiovasc Surg. 1972;64:382–90.PubMedGoogle Scholar
  3. 3.
    McNeill TM, Chamberlain JM. Diagnostic anterior mediastinotomy. Ann Thorac Surg. 1966;2:532–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Naruke T, Asamura H, Kando H, et al. Thoracoscopy for staging of lung cancer. Ann Thorac Surg. 1993;56:661–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Wain JC. Video-assisted thoracoscopy and the staging of lung cancer. Ann Thorac Surg. 1993;56:776–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Roviaro GC, Varoli F, Rebuffat C, et al. Videothoracoscopic staging and treatment of lung cancer. Ann Thorac Surg. 1995;59:971–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Mouroux J, Venissac N, Alifano M. Combined video-assisted thoracoscopy in the management of lung cancer. Ann Thorac Surg. 2001;72:1698–704.PubMedCrossRefGoogle Scholar
  8. 8.
    Metin M, Sayar A, Turna A, et al. Extended cervical mediastinoscopy in the diagnosis of anterior mediastinal masses. Ann Thorac Surg. 2002;73:250–2.PubMedCrossRefGoogle Scholar
  9. 9.
    Specht G. Erweiterte Mediastinoskopie. Thoraxchir Vask Chir. 1965;13:401–7.PubMedGoogle Scholar
  10. 10.
    Hürtgen M, Witte B. History of extended cervical mediastinoscopy. Eur J Cardiothorac Surg. 2009;35:745.PubMedCrossRefGoogle Scholar
  11. 11.
    Kirschner P. “Extended” mediastinoscopy. In: Jepsson O, Ruhbek-Sorensen H, editors. Mediastinoscopy. Odense: Odense University Press; 1971.Google Scholar
  12. 12.
    Ginsberg RJ, Rice TW, Goldberg M, et al. Extended cervical mediastinoscopy. A single staging procedure for bronchogenic carcinoma of the left upper lobe. J Thorac Cardiovasc Surg. 1987;94:673–8.PubMedGoogle Scholar
  13. 13.
    Ginsberg RJ. Extended cervical mediastinoscopy. Chest Surg Clin N Am. 1996;6:21–30.PubMedGoogle Scholar
  14. 14.
    Lopez L, Varela A, Freixinet J, et al. Extended cervical mediastinoscopy: prospective study of fifty cases. Ann Thorac Surg. 1994;57:555–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Call S, Rami-Porta R, Serra-Mitjans M, et al. Extended cervical mediastinoscopy in the staging of bronchogenic carcinoma of the left lung. Eur J Cardiothorac Surg. 2008;34:1081–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Deslauriers J, Beaulieu M, Dufour C, et al. Mediastinopleuroscopy: a new approach to the diagnosis of intrathoracic diseases. Ann Thorac Surg. 1976;22:265–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Urschel JD, Vretenar DF, Dickout WJ, et al. Cerebrovascular accident complicating extended cervical mediastinoscopy. Ann Thorac Surg. 1994;57:740–1.PubMedCrossRefGoogle Scholar
  18. 18.
    Rami-Porta R, Mateu-Navarro M. Surgical methods for lung cancer staging: state of the art. J Bronchol. 2000;7:254–9.CrossRefGoogle Scholar
  19. 19.
    Leyn PD, Lerut T. Conventional mediastinoscopy. Multimed Man Cardiothorac Surg 2005;2005(0324):mmcts.2004.000158. doi:  10.1510/mmcts.2004.000158.
  20. 20.
    Call S, Rami-Porta R, Obiols C. Extended cervical mediastinoscopy. Multimed Man Cardiothorac Surg. 2012;2012:mms018. doi: 10.1093/mmcts/mms018.
  21. 21.
    D’Andrilli A, Venuta F, Rendina EA. Surgical approaches for invasive tumors of the anterior mediastinum. Thorac Surg Clin. 2010;20:265–84.PubMedCrossRefGoogle Scholar
  22. 22.
    Freixinet Gilart J, Garcia PG, de Castro FR, et al. Extended cervical mediastinoscopy in the staging of bronchogenic carcinoma. Ann Thorac Surg. 2000;70: 1641–3.PubMedCrossRefGoogle Scholar
  23. 23.
    Metin M, Citak N, Sayar A, et al. The role of extended cervical mediastinoscopy in staging of non-small cell lung cancer of the left lung and a comparison with integrated positron emission tomography and computer tomography: does integrated positron emission tomography and computed tomography reduce the need for invasive procedures? J Thorac Oncol. 2011;6:1713–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Obiols C, Call S, Rami-Porta R, et al. Extended cervical mediastinoscopy: mature results of a clinical protocol for staging bronchogenic carcinoma of the left lung. Eur J Cardiothorac Surg. 2012;41:1043–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Witte B, Wolf M, Hillebrand H, et al. Extended cervical mediastinoscopy revisited. Eur J Cardiothorac Surg. 2014;45:114–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Kir A, Coskun T, Falay O, et al. The impact of extended mediastinoscopy in left-sided NSCLC patients presenting with suspected N2 disease in #5 and/or #6 stations. Interact Cardiovasc Thorac Surg. 2011;13 Suppl 1:s54.Google Scholar

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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryHospital Universitari Mutua Terrassa, University of BarcelonaTerrassaSpain
  2. 2.Department of Thoracic SurgeryHospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer GroupTerrassaSpain

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