Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/46683
Título: Extended cervical mediastinoscopy: Prospective study of fifty cases
Autores/as: Lopez, Luis
Varela, Andres
Freixinet, Jorge 
Quevedo, Santiago
Pujol, Javier Lopez
de Castro, Felipe Rodriguez 
Salvatierra, Angel
Clasificación UNESCO: 32 Ciencias médicas
3213 Cirugía
Palabras clave: Mediastinoscopy
Thoracic surgery
Case report
Fecha de publicación: 1994
Publicación seriada: The annals of thoracic surgery 
Resumen: To assess the usefulness of extended cervical mediastinoscopy (ECM) in the staging of bronchogenic carcinoma, an ECM was performed prospectively in 50 patients with bronchogenic carcinoma of the left lung. The ECM was used after evaluation of disease operability and computed tomographic findings, and was performed simultaneously with standard cervical mediastinoscopy. In ECM, using the same cervical incision as in a standard cervical mediastinoscopy, dissection is performed behind the anterior face of the sternum. The aortic arch is reached at the level of the origin of the innominate artery. The mediastinoscope is then passed by sliding it along the left anterolateral face of the aortic arch until it reaches the aortopulmonary window. Extended cervical mediastinoscopy was considered positive when a nodal biopsy result consistent with a neofomative process or direct invasion of the mediastinal structures was found. Four patients with positive standard cervical mediastinoscopy and negative ECM were excluded. A false negative ECM was defined as the presence of infiltrated adenopathies at the paraaortic level detected on postoperative histologic study. The ECM was positive in 5 patients in whom operation was contraindicated. Resectability in the remaining 41 patients was 97.6%. Postoperative pathologic study showed infiltrated adenopathy in 3 patients (2 subcarinal, 1 subaortic) accounting for 40 true negatives (the subtarinal group is inaccessible by ECM). This study suggests that ECM has outstanding specificity (100%), sensitivity of 83.3%, and a diagnostic accuracy of 97.8%. A positive predictive value of 100% and a negative predictive value of 97.5% were also identified by this study. We conclude that ECM is a useful technique to assess involvement of the aortopulmonary window in the preoperative staging of bronchogenic carcinoma of the left lung.
URI: http://hdl.handle.net/10553/46683
ISSN: 0003-4975
DOI: 10.1016/0003-4975(94)90544-4
Fuente: The Annals of Thoracic Surgery[ISSN 0003-4975],v. 57, p. 555-558
Colección:Artículos
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