Mediastinoscopy and Thoracoscopy
With the aid of the mediastinoscopy, diseased lymph nodes can be removed for accurate histological determination. This investigation is practicable not only for the primary diagnosis but for the control of the development after X-irradiation too. Complication rates reported in the medical literature vary between 1,4% and 1,7% and fatalities between 0,04% and 0,08%.
The requirement for a successful application of the thoracoscopy, i. e. for a complete examination of the total pleural cavity, is a free pleural space. We have found only localized areas paravertebrally and in the mediastinal pleura, which are not difficult to remove. Our observations raise the question of whether generalized disease of the pleura is indicated bei pleural effusion. Thoracoscopy is almost free of complications and can also be performed with intubation narcosis, if the use of pneumothorax might be fatal for a patient with reduced breathing.
The two investigative procedures discussed can aid diagnosis as well as follow-up observation of lymphadenomatosis.