Mediastinoskopie[*]

Summary

Report about the results of 2500 mediastinal biopsies by mediastinoscopy, the technical experience with this method and the rate of complications. In 1552 investigations done for different reasons it was possible to find characteristic changes in 66% of the mediastinal specimens. In unknown diseases of mediastinum and/or hilar region the percentage was higher (88%) than in processes of the lung parenchyma itself (47%).

Especially in sarcoidosis (98%), silicosis (96%) and malignant processes (80%) there is a remarkable high percentage of positive results.

In 948 routinely examined patients with bronchial carcinoma we found metastases in 34%, more frequently in central position of the tumor (43%) than in the peripheral one (27%); 20% of the lymph node metastase showed a bi- or contralateral involvement.

In 575 simultaneous biopsies by the Daniels method and mediastinoscopy the mediastinal biopsy was more revealing: 74%:26% in bronchial carcinoma, 57%:43% in other malignant diseases. Even in diseases with a high rate of lymph node involvement (Sarcoidosis, silicosis, tuberculosis), the Carlens' biopsy was successful in only 38%. Finally the authors delimit the indications and results from mediastinoscopy to bronchoscopy, pleuroscopy, small diagnostic thoracotomy, transbronchial lymph node biopsy by puncture and parasternal hilar biopsy.

Key-Words

Mediastinoscopy - sarcoidosis - silicosis - malignant diseases - Daniels biopsy - complications

1 Auf Anforderung der Schriftleitung.

1 Auf Anforderung der Schriftleitung.