RE-MEDIASTINOSCOPY IN THE ASSESSMENT OF RESECTABILITY OF LUNG-CANCER

Objective: Thirty-one patients underwent re-mediastinoscopy in the dia gnostic assessment of lung cancer. The reason for a repeat mediastinos copy was either a negative result at the first operation in spire of C T indication of enlarged nodes or an incomplete first mediastinoscopy. Methods: All patients underwent a conventional mediastinoscopy. Resul ts: In 22 patients with enlarged mediastinal lymph nodes at computed t omography, 10 had a positive lymph node histology at re-mediastinoscop y, while 12 were negative. In 9 patients with no enlarged mediastinal nodes at CT scan, but incomplete biopsies at the first mediastinoscopy , 1 patient had lymph node metastases. The median duration from the fi rst to the second mediastinoscopy was 43 days. No major complications occurred. The staging of the patients was greatly affected by the re-m ediastinoscopy. Of 31 patients judged as operable according to the ini tial mediastinoscopy only 60% were found to be operable following the second mediastinoscopy. Conclusion: This study has demonstrated the va lue of re-mediastinoscopy in assessment of resectability of lung cance r. (C) 1997 Elsevier Science B.V.