Mediastinoscopy

(Redirected from Mediastinotomy)

Mediastinoscopy is a procedure that enables visualization of the contents of the mediastinum, usually for the purpose of obtaining a biopsy.[1] Mediastinoscopy is often used for staging of lymph nodes of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma.

Mediastinoscopy
ICD-9-CM34.22
MeSHD008481
OPS-301 code1-691.1

Mediastinoscopy involves making an incision approximately 1 cm above the suprasternal notch of the sternum, or breast bone. Dissection is carried out down to the pretracheal space and down to the carina. A scope (mediastinoscope) is then advanced into the created tunnel which provides a view of the mediastinum. The scope may provide direct visualization or may be attached to a video monitor.

Mediastinoscopy provides access to mediastinal lymph node levels 2, 4, and 7.

Current use

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Historically, mediastinoscopy has been the gold standard for the staging of lung cancer. However, with advances in minimally invasive procedures and imaging, mediastinoscopy usage has declined significantly from 2006 to 2010.[2]

Extended mediastinoscopy

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Extended mediastinoscopy is a technique which allows access to the pre-aortic (station 6) and aortopulmonary window (station 5) lymph nodes.[citation needed]

Parasternal mediastinotomy

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Parasternal mediastinotomy, aka, a Chamberlain procedure, is the standard approach to access lymph nodes at stations 5 and 6.[citation needed]

References

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  1. ^ Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 1853–1854. ISBN 978-0-07-145739-2.
  2. ^ Vyas, Krishna S.; Davenport, Daniel L.; Ferraris, Victor A.; Saha, Sibu P. (2013). "Mediastinoscopy". Southern Medical Journal. 106 (10): 539–44. doi:10.1097/SMJ.0000000000000000. PMC 4387790. PMID 24096946.