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Revista americana de medicina respiratoria

On-line version ISSN 1852-236X

Abstract

DEFRANCHI, Sebastián et al. El valor predictivo negativo de la mediastinoscopía realizada por cirujanos torácicos. Rev. am. med. respir. [online]. 2016, vol.16, n.1, pp.17-22. ISSN 1852-236X.

Background: Although mediastinoscopy is the gold standard in the preoperative diagnosis of lung cancer mediastinal disease, recent publications have addressed the role of newer less invasive methods, suggesting that they are at least, as valid as mediastinoscopy. Our objective was to report the false negative rate, negative predictive value and sensitivity of mediastinoscopy when performed by certified chest surgeons. Methods: The study included all patients who underwent mediastinoscopy at the General Thoracic Surgery Unit of the Hospital Universitario Fundación Favaloro from 2009 up to 2015. Medical, pathology and surgical reports were reviewed. Results: 82 patients underwent mediastinoscopy during the study period; 50 patients were men. Median age was 61 years. In all patients samples of lymph node tissue were obtained. The false negative rate of mediastinoscopy was 7/82 patients. The negative predictive value and the sensitivity of the procedure were 84%. There was one intraoperative complication. The mediastinoscopy related mortality rate was 0%. Conclusions: Mediastinoscopy is safe and has a high negative predictive value when it is performed by certifed chest surgeons. Samples of lymphatic tissue for biopsy can be obtained in 100% of the cases. These values should be used for comparisons with any newer minimally invasive methods designed to replace mediastinoscopy.

Keywords : Mediastinoscopy; Lung cancer; Lymph node dissection.

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