Among the several techniques to stage the mediastinum, the most important in the hands of thoracic surgeons remains mediastinoscopy. As a minimal invasive procedure, it allows approach to most parts of the middle compartment of the mediastinum. Besides staging of lung cancer patients, mediastinoscopy is also widely used to diagnose undefined mediastinal masses. In 1959, the Swedish thoracic surgeon Eric Carlens  for the first time described mediastinoscopy. With the existing limited radiological options in patients with lung cancer, Carlens wished to obtain information on potential mediastinal tumour spread prior to surgery, since it was not unusual to find inoperable tumours at thoracotomy. Nowadays, the importance of mediastinoscopy in lung cancer lies in the exact determination of the tumour stage. Tumour stage strongly affects survival, especially in stages I to III, since these have far differing prognosis depending on the involvement of mediastinal lymph nodes. In addition, according to current studies, neoadjuvant treatment in stage III increases life expectancy ; therefore, mediastinal staging needs to be as accurate as possible even in non-enlarged lymph nodes.
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Carlens E (1959) Mediastinoscopy: a method for inspection a tissue biopsy in the superior mediastinum. Dis Chest 36:343–352PubMedCrossRefGoogle Scholar
De Leyn P, Lardinois D, Van Schil PE et al (2007) ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg 32(1):1–8PubMedCrossRefGoogle Scholar
Detterbeck FC, Jantz MA, Wallace M et al (2007) Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132(3 Suppl):202S–220SPubMedCrossRefGoogle Scholar
Ernst A, Anantham D, Eberhardt R et al (2008) Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy. J Thorac Oncol 3(6):577–582PubMedCrossRefGoogle Scholar
Herth FJ, Eberhardt R, Krasnik M et al (2008) Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomography-normal mediastinum in patients with lung cancer. Chest 133(4):887–891PubMedCrossRefGoogle Scholar
Hürtgen M, Friedel G, Toomes H et al (2002) Radical video-assisted mediastinoscopic lymphadenectomy (VAMLA) – technique and first results. Eur J Cardiothorac Surg 21(2):348–351PubMedCrossRefGoogle Scholar
Kuzdzał J, Zieliński M, Papla B et al (2007) The transcervical extended mediastinal lymphadenectomy versus cervical mediastinoscopy in non-small cell lung cancer staging. Eur J Cardiothorac Surg 31(1):88–94PubMedCrossRefGoogle Scholar
Leschber G, Holinka G, Linder A (2003) Video-assisted mediastinoscopic lymphadenectomy (VAMLA) – a method for systematic mediastinal lymph node dissection. Eur J Cardiothorac Surg 24(2):192–195PubMedCrossRefGoogle Scholar
Leschber G, Sperling D, Klemm W et al (2008) Does video-mediastinoscopy improve the results of conventional mediastinoscopy? Eur J Cardiothorac Surg 33(2):289–293PubMedCrossRefGoogle Scholar
Silvestri GA, Gould MK, Margolis ML et al (2007) Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 132(3 Suppl):178S–201SPubMedCrossRefGoogle Scholar