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      The role of mediastinoscopy in the diagnosis of non-lung cancer diseases

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          Abstract

          Background

          Mediastinoscopy is a good method to evaluate mediastinal lesions. We sought to determine the current role of mediastinoscopy in the investigation of non-lung cancer patients with mediastinal lymphadenopathy.

          Materials and methods

          We retrospectively reviewed clinical parameters (age, gender, histological diagnosis, morbidity, mortality) of all patients without lung cancer who consecutively underwent mediastinoscopy in Hospital of Faculty of Medicine of Dicle University between June 2003 and December 2016.

          Results

          Two-hundred twenty nine patients without lung cancer who underwent mediastinoscopy for the pathological evaluation of mediastinum during the study period were included. There were 156 female (68%) and 73 male (32%) patients. Mean age was 52.6 years (range, 16 to 85 years). Mean operative time was 41 minutes (range, 25 to 90 minutes). Mean number of biopsies was 9.3 (range, 5 to 24). Totally, 45 patients (19.6%) had previously undergone a nondiagnostic bronchoscopic biopsy such as transbronchial needle aspiration or endobronchial ultrasound-guided transbronchial needle aspiration. Mediastinoscopy was diagnostic for all patients. Diagnosis included sarcoidosis (n=100), tuberculous lymphadenitis (n=66), anthracosis lymphadenitis (n=44), lymphoma (n=11) metastatic carcinoma (n=5), and Castleman’s disease (n=1); there was a diagnosis of silicosis in one patient and tymoma in one patient. Neither operative mortality nor major complication developed. The only minor complication was wound infection which was detected in three patients.

          Conclusion

          Although newer diagnostic modalities are being increasingly used to diagnose mediastinal diseases, mediastinoscopy continues to be a reliable method for the investigation of mediastinal lesions.

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          Most cited references 29

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          Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999.

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            ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders.

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              Regional lymph node classification for lung cancer staging.

               C Dresler,  C Mountain (1997)
              Recommendations for classifying regional lymph node stations for lung cancer staging have been adopted by the American Joint Committee on Cancer (AJCC) and the Union Internationale Contre le Cancer. The objective was to unify the two systems that have been in common use for the past 10 years; that is, the schema advocated by the AJCC, adapted from the work of Tsuguo Naruke, and the schema advocated by the American Thoracic Society and the North American Lung Cancer Study Group. Anatomic landmarks for 14 hilar, intrapulmonary, and mediastinal lymph node stations are designated. This classification provides for consistent, reproducible, lymph node mapping that is compatible with the international staging system for lung cancer. It is applicable for clinical and surgical-pathologic staging.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2017
                27 July 2017
                : 13
                : 939-943
                Affiliations
                [1 ]Department of Thoracic Surgery, Faculty of Medicine, Dicle University
                [2 ]Department of Chest Diseases, Memorial Hospital, Diyarbakir
                [3 ]Department of Thoracic Surgery, Faculty of Medicine, Çukurova University, Adana
                [4 ]Department of Chest Diseases, Yuksek Ihtisas Education and Research Hospital, Bursa
                [5 ]Department of Radiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
                Author notes
                Correspondence: Serdar Onat, Department of Thoracic Surgery, Faculty of Medicine, Dicle University, Kitilbil Street, Sur, 21280, Diyarbakir,Turkey, Tel +90 412 248 8003, Email onatserdar21@ 123456hotmail.com
                Article
                tcrm-13-939
                10.2147/TCRM.S144393
                5538683
                © 2017 Onat et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Medicine

                lymph node, mediastinoscopy, mediastinum, granulomatous diseases, lymphadenopathy

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