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Mediastinoscopy

Mediastinoscopy is a minimally invasive surgical procedure used to examine and biopsy the mediastinal lymph nodes.
It is commonly employed in the diagnosis and staging of lung cancer, as well as the evaluation of other thoracic conditions.
The procedure involves making a small incision in the neck and inserting a thin, lighted instrument called a mediastinoscope into the chest to visualize the mediastinal structures.
Mediastinoscopy allows for the collection of tissue samples for pathological analysis, aiding in the accurate diagnosis and treatment planning.
This important diagnostic tool helps healthcare providers make informed decisions about the most appropriate course of management for their patients.

Most cited protocols related to «Mediastinoscopy»

1
Neoadjuvant Nivolumab for Resectable NSCLC
This single-group study was developed by the authors and conducted at two medical centers in the United States. The patients received two doses of intravenous nivolumab (at a dose of 3 mg per kilogram of body weight) every 2 weeks. It was planned that surgery would be performed approximately 4 weeks after the first dose. All the patients provided written informed consent.
The primary end points were safety and feasibility. The key secondary and exploratory end points were radiologic and pathological responses to treatment and immunologic, genomic, and pathological correlates of response in blood and tumor (Fig. S1 in Supplementary Appendix 1, available with the full text of this article at NEJM.org).
All the patients were monitored for adverse events, according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.12 Feasibility was prospectively defined as any delay in the planned surgery of no more than 37 days (i.e., a surgical delay of >30 days and 7 days for scheduling). In a safety run-in phase, an initial 6 patients were followed for perioperative adverse events of grade 3 or 4 for 90 days after the administration of the last nivolumab dose (or day 30 after surgery). With the goal of exploring the antitumor immune response in depth, the study then expanded to enroll a total of 20 patients who underwent complete tumor resection.
All the patients underwent baseline tumor staging, including pretreatment biopsy, pathological evaluation of mediastinal lymph nodes (if indicated) by means of bronchoscopy or mediastinoscopy, positron-emission tomography–computed tomography (PET–CT), and contrast-enhanced CT or magnetic resonance imaging of brain and chest; chest CT was repeated within 7 days before surgery. Changes in tumor size were evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1.13 (link) Resection of the primary tumor and lymph nodes was completed according to institutional standards. All the patients were offered conventional adjuvant chemotherapy or radiotherapy, if such therapy was clinically indicated, and were followed for recurrence-free and overall survival.
Forde P.M., Chaft J.E., Smith K.N., Anagnostou V., Cottrell T.R., Hellmann M.D., Zahurak M., Yang S.C., Jones D.R., Broderick S., Battafarano R.J., Velez M.J., Rekhtman N., Olah Z., Naidoo J., Marrone K.A., Verde F., Guo H., Zhang J., Caushi J.X., Chan H.Y., Sidhom J.W., Scharpf R.B., White J., Gabrielson E., Wang H., Rosner G.L., Rusch V., Wolchok J.D., Merghoub T., Taube J.M., Velculescu V.E., Topalian S.L., Brahmer J.R, & Pardoll D.M. (2018). Neoadjuvant PD-1 Blockade in Resectable Lung Cancer. The New England journal of medicine, 378(21), 1976-1986.
Publication 2018
Aftercare Biopsy BLOOD Body Weight Brain Bronchoscopy Chemotherapy, Adjuvant Chest Genome Mediastinoscopy Mediastinum Neoplasms Nivolumab Nodes, Lymph Operative Surgical Procedures Patients Radiotherapy Recurrence Response, Immune Safety Scan, CT PET Surgery, Day Therapeutics
2
Rigorous Mediastinal Lymph Node Dissection

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Publication 2011
Aortopulmonary Septal Defect Arm, Upper Bronchi Bronchus, Primary Cryoultramicrotomy Dissection Eligibility Determination Esophagus Ethics Committees, Research Ligaments Lung Lung Neoplasms Lymph Node Dissection Lymph Node Excision Lymphoid Tissue Malignant Neoplasms Mediastinal Neoplasms Mediastinoscopy Mediastinum Mucocutaneous Lymph Node Syndrome Muscle Rigidity Neoplasms Nervousness Nodes, Lymph Non-Small Cell Lung Carcinoma Patients Pericardium Stem, Plant Surgeons Teaching Thoracic Surgery, Video-Assisted Thoracotomy Trachea Trunks, Brachiocephalic Vena Cavas, Superior
3
Surgical vs. Stereotactic Radiotherapy for Elderly Lung Cancer Patients
In this Institutional Review Board approved retrospective study, patients aged ≥70 years, who received surgery or SBRT for T1–2 N0 M0 clinically confirmed lung cancer from January 2012 to December 2017 were eligible for inclusion. Clinically confirmed lung carcinoma was defined as a primary suspicious mass, part-solid, or ground-glass opacity nodule with spiculated or smooth margins on CT images, that persisted for ≥3 months and showed an increase in its longest axis. Patients with radiologically suspicious lymph nodes underwent endobronchial ultrasonography or mediastinoscopy. In addition, all patients underwent bone imaging and brain magnetic resonance imaging. Positron emission-computed tomography (PET/CT) was necessary for diagnosis in cases in whom biopsy was not considered medically safe or the patient refused to undergo biopsy, and recommended for all patients. Disease staging was performed using the Union for International Cancer Control TNM Classification of Malignant Tumors, 7th edition. The multidisciplinary team (i.e., surgeons, radiation oncologists, and diagnostic radiologists) examined and discussed the SBRT indications prior to the initiation of treatment. All multidisciplinary consultations were recorded in detail.
Patients with adequate pulmonary function and absence of other contraindicating medical comorbidities – according to the thoracic surgeon – were selected for surgery resection. The performance of a lobectomy, sub-lobectomy, thoracotomy, or video-assisted thoracic surgery (VATS) was discussed among the multidisciplinary team prior to the procedure. Radical lymph node dissection was performed in accordance with the current guidelines [15 (link)].
Inoperable patients – according to the thoracic surgeon – and those who refused surgical resection were selected for SBRT. The whole process of SBRT has been described previously in detail in our previous study [16 (link), 17 (link)]. The gross tumor volume (GTV) included only the primary tumor; the internal target volume (ITV) was determined using CT with a four-dimension CT technique, and the tumor motion was assessed. The planning target volume (PTV) was defined as the ITV expanded by a 5-mm margin in each direction. The dose of SBRT was prescribed to the highest isodose line, which needed to cover 100% of the ITV and > 95% of the PTV. The treatment plans were optimized to limit the administration of high doses to regions of organs at risk. Twenty (20%) SBRT patients received more conservative fractionation schedules with a lower dose per fraction but more fractions, due to larger tumors or those adjacent to critical organs. The biological effective dose (BED) was calculated using BEDα/β = nd (1+ d/α/β), where n = number of fractions, d = dose per fraction, and α/β = 10 for the tumor in line with prior studies.
Dong B., Wang J., Zhu X., Chen Y., Xu Y., Shao K., Zheng L., Ying H., Chen M, & Cao J. (2019). Comparison of the outcomes of stereotactic body radiotherapy versus surgical treatment for elderly (≥70) patients with early-stage non-small cell lung cancer after propensity score matching. Radiation Oncology (London, England), 14, 195.
Publication 2019
Biopharmaceuticals Biopsy Bones Brain Diagnosis Epistropheus Ethics Committees, Research Four-Dimensional Computed Tomography Infantile Neuroaxonal Dystrophy Lung Lung Cancer Lymph Node Excision Malignant Neoplasms Mediastinoscopy Neoplasms Nodes, Lymph Operative Surgical Procedures Patients Positron-Emission Tomography Radiation Oncologists Radiologist Radiotherapy Dose Fractionations Surgeons Thoracic Surgery, Video-Assisted Thoracotomy Ultrasonography
4
Stage I NSCLC Treatment Outcomes

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Publication 2019
Biopharmaceuticals Bones Brain Chest Diagnosis F18, Fluorodeoxyglucose Infantile Neuroaxonal Dystrophy Lung Lymph Node Excision Malignant Neoplasms Mediastinoscopy Neoplasm Metastasis Neoplasms Nodes, Lymph Non-Small Cell Lung Carcinoma Operative Surgical Procedures Patients Positron-Emission Tomography Radiation Oncologists Radiologist Recurrence Surgeons Therapeutics Tissues Ultrasonography Unite resin X-Ray Computed Tomography
5
Comprehensive Staging for Lung Cancer
Patients with radiological N0 disease without distant metastasis either underwent pre-operative EBUS-TBNA or directly proceeded to surgical resection at the discretion of attending physicians, since there was no consistent indication for pre-operative EBUS-TBNA in patients with radiological N0 disease. EBUS-TBNA was performed with a convex probe EBUS bronchoscope (BF-UC260F-OL8; Olympus, Tokyo, Japan) and a 22-gauge needle (NA-201SX-4022; Olympus) under moderate sedation with intravenous midazolam and fentanyl. After systematic inspection of lymph node stations, each visible lymph node was sampled in the standard N3 to N2 to N1 fashion, with size cut-offs of ≥5 mm in the short axis by EBUS. We conducted three passes per node and at least two passes when core tissue was obtained [17 (link), 18 (link)]. Transoesophageal bronchoscopic ultrasound-guided fine-needle aspiration (EUS-FNA-B) using the EBUS bronchoscope was done in selected cases [19 (link)]. Rapid on-site cytopathological evaluation was not available. When the clinical suspicion of mediastinal metastasis remained high despite a negative result in EBUS-TBNA, pre-operative mediastinoscopy was performed. Otherwise, surgical resection with MLND was considered if there was no metastasis to mediastinal lymph nodes in EBUS-TBNA.
The surgical procedures included resection of the affected lung plus lymph node dissection of the ipsilateral hilum and mediastinum, including all visible and palpable lymph nodes irrespective of size [20 (link), 21 (link)]. MLND consisted of en bloc resections of all nodes at stations 10R, 9, 8, 7, 4R, 3 and 2R for right-sided tumours and nodes at stations 10L, 9, 8, 7, 6, 5 and 4L for left-sided tumours.
Shin S.H., Jeong D.Y., Lee K.S., Cho J.H., Choi Y.S., Lee K., Um S.W., Kim H, & Jeong B.H. (2019). Which definition of a central tumour is more predictive of occult mediastinal metastasis in nonsmall cell lung cancer patients with radiological N0 disease?. The European Respiratory Journal, 53(3), 1801508.
Publication 2019
Aspiration Biopsy, Fine-Needle Bronchoscopes Conscious Sedation Dissection Endoscopic Ultrasound-Guided Fine Needle Aspiration Epistropheus Fentanyl Lung Lymph Node Excision Lymph Node Metastasis Mediastinoscopy Mediastinum Midazolam Needles Neoplasm Metastasis Neoplasms Nodes, Lymph Operative Surgical Procedures Patients Physicians Rapid On-site Evaluation Tissues Ultrasonics X-Rays, Diagnostic

Most recents protocols related to «Mediastinoscopy»

1
Preoperative Predictors of Postoperative Pulmonary Complications
The following data were recorded during the preoperative examination: Sex, age, height, body weight, BMI, smoking history, complete blood count (leukocytes, hemoglobin, platelets), liver function tests (liver enzymes, albumin), renal function tests, preoperative oxygen saturation, history of previous surgery, and concomitant diseases (type 2 diabetes, hypertension, pulmonary and cardiac diseases).
The following data were also collected: History and physical examination findings, chest radiographs, computed tomographic examinations of the chest (CT), electrocardiography (ECG) and echocardiography (if required), pulmonary function test results (forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio), and arterial blood gases. In patients with lung cancer, the type and stage of malignancy were determined, and flexible bronchoscopy was performed.
During the intraoperative process, the type of endotracheal tube, the duration of anesthesia and surgery, the surgical procedure (VATS, thoracotomy, mediastinoscopy, and others) performed, and complications that required intraoperative treatment were also noted.
PPCs have been defined as complications that occur in the postoperative period and cause clinical conditions.
Eldaabossi S., Al-Ghoneimy Y., Ghoneim A., Awad A., Mahdi W., Farouk A., Soliman H., Kanany H., Antar A., Gaber Y., Shaarawy A., Nabawy O., Atef M., Nour S.O, & Kabil A. (2023). The ARISCAT Risk Index as a Predictor of Pulmonary Complications After Thoracic Surgeries, Almoosa Specialist Hospital, Saudi Arabia. Journal of Multidisciplinary Healthcare, 16, 625-634.
Publication 2023
Albumins Anesthesia Arteries Blood Gas Analysis Blood Platelets Body Weight Bronchoscopy Chest Complete Blood Count concomitant disease Diabetes Mellitus, Non-Insulin-Dependent Echocardiography Electrocardiography Enzymes Exhaling Forced Vital Capacity Heart Diseases Hemoglobin High Blood Pressures Kidney Function Tests Leukocytes Liver Liver Function Tests Lung Lung Cancer Mediastinoscopy Operative Surgical Procedures Oxygen Saturation Patients Physical Examination Radiography, Thoracic Staging, Cancer Tests, Pulmonary Function Thoracic Surgery, Video-Assisted Thoracotomy Training Programs Volumes, Forced Expiratory X-Ray Computed Tomography
2
Thoracic Surgery Protocols Inventory
All patients who underwent various types of thoracic surgery (thoracotomy, thoracoscopy (medical and surgical), mediastinoscopy, mediastinotomy, or sternotomy) regardless of age or gender during the study period were included.
Eldaabossi S., Al-Ghoneimy Y., Ghoneim A., Awad A., Mahdi W., Farouk A., Soliman H., Kanany H., Antar A., Gaber Y., Shaarawy A., Nabawy O., Atef M., Nour S.O, & Kabil A. (2023). The ARISCAT Risk Index as a Predictor of Pulmonary Complications After Thoracic Surgeries, Almoosa Specialist Hospital, Saudi Arabia. Journal of Multidisciplinary Healthcare, 16, 625-634.
Publication 2023
Gender Mediastinoscopy Operative Surgical Procedures Patients Sternotomy Thoracic Surgical Procedures Thoracoscopy Thoracotomy
3
Surgical Procedures Database Analysis
Categories of common surgical purposes and procedures were set across the fields and included transplantation surgery, trauma surgery, surgical oncology (operations of malignant disease), endoscopic and minimum invasive surgery, including robot-assisted surgery, and the number of corresponding programs were counted. As an example of advanced medical technologies, mediastinoscopic radical esophagectomy for esophageal cancer [5 (link)–7 (link)], transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) for rectal cancer [8 (link), 9 (link)], laparoscopic pancreaticoduodenectomy (Lap-PD) for pancreatic lesions [10 (link)], and minimally invasive cardiac surgery (MICS) for cardiovascular lesions [11 (link)] were selected, and their numbers were counted.
Shichinohe T., Date H., Hatano E., Kobayashi E., Hiramatsu M., Hirano S., Izawa Y, & Shirakawa Y. (2023). Cadaver surgical training and research using donated cadavers in the field of surgery in Japan: an overview of reports from 2012 to 2021. Surgery Today.
Publication 2023
Cardiovascular System Endoscopy Esophageal Cancer Esophagectomy Heart Laparoscopy Malignant Neoplasms Mediastinoscopy Minimally Invasive Surgical Procedures Operative Surgical Procedures Pancreas Pancreaticoduodenectomy Proctectomy Robotic Surgical Procedures Transanal Minimally Invasive Surgery Transplantation Wounds and Injuries
4
Multimodal Management of Advanced NSCLC
All patients underwent baseline tumor staging, including contrast-enhanced computed tomography (CT) of brain, chest and abdomen, positron-emission tomography-CT (PET-CT), and pathological evaluation of any enlarged mediastinal lymph nodes by means of bronchoscopy and/or mediastinoscopy. Classification of NSCLC was based on the 8th edition of TNM by the International Association for the Study of Lung Cancer (12 (link)). All cases were discussed in multidisciplinary meetings. Decision to initiate systemic treatment was based on advanced unresectable clinical stage IIIB to IVB disease, with treatment protocols varying according to the oncologic center as well as the use of durvalumab “off label”. Introduction of ICI was either at first, second or third line of treatment, depending upon the oncologic center protocols. Radical management of metastases were as followed. Persistent adrenal gland metastases were treated by surgical resection or radiotherapy. Liver metastases and distant lymph nodes metastases disappeared under immunotherapy. Brain and bone metastases were treated by radiotherapy. All patients underwent a complete reassessment of the tumor with CT and PET-CT within 6 weeks before surgery. Upon reassessment, eligibility to surgical resection was suggested in case of well controlled patient and an operable patient. Patients were defined as “well controlled” on the following criteria:
Once the patients were defined as well controlled, selection for surgical resection was based on:
Etienne H., Fournel L., Mordant P., Delatour B.R., Pfeuty K., Frey G., Seguin-Givelet A., Fourdrain A., Lancelin C., Berna P., Legras A., Alifano M., Bagan P, & Assouad J. (2023). Anatomic lung resection after immune checkpoint inhibitors for initially unresectable advanced-staged non-small cell lung cancer: a retrospective cohort analysis. Journal of Thoracic Disease, 15(2), 270-280.
Publication 2023
Abdomen Adrenal Glands Bones Brain Bronchoscopy Chest durvalumab Eligibility Determination Immunotherapy Liver Lung Cancer Lymph Node Metastasis Mediastinoscopy Mediastinum Neoplasm Metastasis Neoplasms Nodes, Lymph Non-Small Cell Lung Carcinoma Operative Surgical Procedures Patients Radiotherapy Scan, CT PET Treatment Protocols X-Ray Computed Tomography
5
Segmentectomy for Early-Stage Lung Cancer
Before surgery, all cases were individually discussed in a multidisciplinary tumour board. Preoperative assessment included a chest CT and fluorodeoxyglucose-positron emission tomography scan with maximum standard uptake values and a transthoracic or bronchoscopic biopsy of the lesion to determine the histology when technically feasible. In case of suspected lymph node involvement on preoperative imaging, an endobronchial ultrasound fine-needle aspiration or mediastinoscopy was performed before surgery. The choice of treatment modality (lobectomy versus segmentectomy) was driven by unmeasured patient characteristics, but we usually favoured a segmentectomy in case of smaller, peripherally located lesions in a specific segment with an achievable surgical margin of ≥2 cm.
Patients were operated under general anaesthesia with single lung ventilation by double lumen intubation. A standardized 3-port anterior approach (utility incision in the 4th intercostal space, 1 incision for the 10 mm 30° thoracoscope in the 7th intercostal space anteriorly and a 3rd incision posteriorly) or 1-port approach (since 2018) were used. Segmentectomy procedures were performed with individual dissection of the segmental bronchus, arteries and veins followed by a systematic hilar and mediastinal lymph node resection. Intersegmental plane was identified using systemic injection of indocyanine green when necessary and the dissection itself was performed by using stapling or energy device. Surgical margins were systematically evaluated and all types of segmentectomies were performed. In case of suspected hilar nodal involvement, a frozen section was performed and a completion lobectomy was undertaken if the nodal status was upstaged (N1). Surgical specimens were extracted through a protective bag.
All cases were discussed again after surgery in a multidisciplinary tumour board to assess the need of adjuvant chemotherapy. The follow-up consisted in chest CT scans every 3 months for the 1st 2 years, then every 6 months for a total of 5 years.
Forster C., Abdelnour-Berchtold E., Bédat B., Perentes J.Y., Zellweger M., Sauvain M.O., Christodoulou M., Triponez F., Karenovics W., Krueger T, & Gonzalez M. (2023). Local control and short-term outcomes after video-assisted thoracoscopic surgery segmentectomy versus lobectomy for pT1c pN0 non-small-cell lung cancer. Interdisciplinary Cardiovascular and Thoracic Surgery, 36(2), ivad037.
Publication 2023
Arteries Aspiration Biopsy, Fine-Needle Biopsy Bronchoscopes Chemotherapy, Adjuvant Chest Cryoultramicrotomy Dissection F18, Fluorodeoxyglucose General Anesthesia Indocyanine Green Intubation Lymph Node Excision Mediastinoscopy Mediastinum Medical Devices Neoplasms Nodes, Lymph One-Lung Ventilation Operative Surgical Procedures Patients Positron-Emission Tomography Segmental Mastectomy Selection for Treatment Surgical Margins Tertiary Bronchi Thoracoscopes Ultrasonics Veins X-Ray Computed Tomography

Top products related to «Mediastinoscopy»

1
Stata statistical analysis software by StataCorp
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STATA is a general-purpose statistical software package that provides a wide range of data analysis, data management, and graphics capabilities. It is designed for researchers, analysts, and students working in various fields, including economics, social sciences, and health sciences. STATA offers a comprehensive set of tools for data manipulation, statistical modeling, time series analysis, and more.
2
Osirix imaging software by Pixmeo
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OsiriX is an open-source DICOM viewer software designed for macOS. It provides a comprehensive set of tools for visualization and analysis of medical images, with a focus on DICOM data from radiological imaging modalities such as CT, MRI, and PET scans.
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Bf uc260fw by Olympus
Sourced in Japan
The BF-UC260FW is a benchtop microscope designed for clinical and laboratory applications. It features a trinocular observation head, allowing for both visual observation and camera integration. The microscope is equipped with Olympus' UIS2 optical system and offers a range of magnification options to suit various sample types.
4
Statistical package for social sciences v 22.0 by IBM
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The Statistical Package for Social Sciences (v.22.0) is a comprehensive software suite designed for statistical analysis. It provides a wide range of tools and techniques for data management, analysis, and presentation. The core function of this product is to enable researchers, analysts, and professionals to effectively manage, analyze, and interpret complex data sets.
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Pro 2020 by TreeAge
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Da vinci s by Intuitive Surgical
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The da Vinci S is a robotic surgical system developed by Intuitive Surgical. It is designed to assist surgeons in performing minimally invasive procedures. The system includes a surgeon's console, a patient-side cart, and a high-performance vision system. The da Vinci S provides surgeons with enhanced visualization, improved dexterity, and precise control during surgical procedures.
7
Eu me2 by Olympus
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Da vinci system by Intuitive Surgical
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The da Vinci System is a surgical robot designed for minimally invasive surgery. It consists of a surgeon's console, a patient-side cart with four interactive robotic arms, a high-definition 3D vision system, and specialized surgical instruments. The system allows the surgeon to perform complex surgical procedures with enhanced precision, flexibility, and control.
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Spss version 23 by IBM
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Statistical package for social sciences version 22 by IBM
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SPSS Statistics version 22.0 is a software package used for statistical analysis. It provides tools for data management, data analysis, and presentation of results. The software is designed to work with a variety of data types and can be used for a range of statistical procedures, including descriptive statistics, regression analysis, and hypothesis testing.

More about "Mediastinoscopy"

Mediastinoscopy is a minimally invasive surgical procedure used to examine and biopsy the mediastinal lymph nodes, a crucial diagnostic tool in the management of thoracic conditions.
This procedure involves making a small incision in the neck and inserting a thin, lighted instrument called a mediastinoscope into the chest to visualize the mediastinal structures.
Mediastinoscopy is commonly employed in the diagnosis and staging of lung cancer, as well as the evaluation of other thoracic malignancies and conditions, such as sarcoidosis, lymphoma, and infectious diseases.
By collecting tissue samples for pathological analysis, mediastinoscopy aids in accurate diagnosis and treatment planning, helping healthcare providers make informed decisions about the most appropriate course of management for their patients.
Researchers and clinicians may utilize various software and tools to optimize their mediastinoscopy research protocols, such as STATA statistical analysis software, OsiriX imaging software, and the BF-UC260FW bronchoscope.
The Statistical Package for Social Sciences (v.22.0) and TreeAge Pro 2020 can also be employed in the analysis and interpretation of data related to mediastinoscopy procedures.
Furthermore, the Da Vinci S and EU-ME2 robotic systems have been used in minimally invasive mediastinal surgeries, including mediastinoscopy.
The SPSS version 23 statistical software is another tool that can be leveraged to analyze the outcomes and efficacy of mediastinoscopy in clinical research.