Cervical Mediastinoscopy as a Diagnostic Tool for Mediastinal Lymphadenopathy.

IF 0.7 4区医学 Q3 MEDICINE, GENERAL & INTERNAL Jcpsp-Journal of the College of Physicians and Surgeons Pakistan Pub Date : 2023-09-01 DOI:10.29271/jcpsp.2023.09.1062

Farhan Ahmad Majeed, Kamran Raheem, Usama Zafar, Sohail Saqib Chatha, Ahmad Raza, Arshman Rauf

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Abstract

Objective: To determine the yield of cervical mediastinoscopy in determining causes of mediastinal lymph node enlargement.

Study design: Observational study. Place and Duration of the Study: CMH Rawalpindi, Lahore and Multan, from January 2010 to December 2021.

Methodology: Patients who underwent lymph node biopsy through cervical mediastinoscopy approach were included. Record of the patients including age, gender, clinical presentation, and findings on CT scan chest were noted along with the record of preoperative complications and duration of surgery. Histopathology report was also recorded.

Results: Out of 398 patients, 259 (65%) were males and 139 (35%) were females. Out of 338 patients who were operated for diagnostic purpose, 157 (46%) had tuberculosis and 34 (10.1%) had sarcoidosis. Fifty-two (15.3%) were diagnosed to have malignancy including non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), and metastatic carcinoma of unspecified origin. Amongst staging group (n=60), 33 (55%) patients had negative mediastinal disease. Complication rate was 3.8%, including hoarseness of voice in three patients while 2 patients had wound infection requiring intervention.

Conclusion: Cervical mediastinoscopy is a safe and efficacious means of diagnosis in indeterminate mediastinal lymphadenopathy and staging of lung malignancy.

Key words: Mediastinoscopy, Lymph nodes, Tuberculosis, Lung cancer, Staging.

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颈纵隔镜作为纵隔淋巴结病的诊断工具。

目的:探讨颈纵隔镜检查在诊断纵隔淋巴结肿大原因中的应用价值。研究设计:观察性研究。研究地点和时间:2010年1月至2021年12月，拉瓦尔品第、拉合尔和木尔坦的CMH。方法:纳入经颈纵隔镜入路行淋巴结活检的患者。记录患者的年龄、性别、临床表现、胸部CT扫描结果，并记录术前并发症和手术时间。同时记录组织病理学报告。结果:398例患者中，男性259例(65%)，女性139例(35%)。在为诊断目的进行手术的338例患者中，157例(46%)患有结核病，34例(10.1%)患有结节病。52例(15.3%)被诊断为恶性肿瘤，包括非小细胞肺癌(NSCLC)、小细胞肺癌(SCLC)和来源不明的转移性癌。在分期组(n=60)中，33例(55%)患者的纵隔疾病呈阴性。并发症发生率为3.8%，其中嗓音嘶哑3例，伤口感染2例，需干预。结论:宫颈纵隔镜检查对不确定的纵隔淋巴结病及肺恶性肿瘤分期是一种安全有效的诊断手段。关键词:纵隔镜检查，淋巴结，结核，肺癌，分期

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来源期刊

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

453

审稿时长

3-6 weeks

期刊介绍： Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991. Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.