Mediastinoscopy is an endoscopic examination of the superior mediastinum through a cervical incision. It allows examination and biopsy of the lymphatic chains around the trachea, both paratracheal chains and those at the main carina. As these gland groups are commonly involved by carcinoma of the bronchus ascending through the mediastinum, mediastinoscopy may be used to obtain tissue diagnosis in advanced carcinomas of the lung or to assess the extent of nodal involvement, which many surgeons feel is important in deciding on the desirability of resection. Mediastinoscopy also permits examination of other structures within the superior mediastinum which may be directly invaded by tumours of the upper lobe, and hence may help in deciding upon the resectability of the condition.
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