Use Of Mediastinoscopy In The Approach OF Mediastinal Lymphadenopathy

Abstract

Background and objective: The mediastinal nodes enlarge in many benign and malignant pulmonary diseases. Infections, tumors, and inflammatory diseases are the most common causes. Mediastinoscopy can be useful in diagnosing mediastinal lymphadenopathy, treating other masses in the mediastinum as in bronchial cysts, emptying and blasting, and assessing mediastinal elements in cases of The collection of purulent, chylus or blood within the mediastinum. This study includes an evaluation of the use of mediastinoscopy in Al-Assad University Hospital in Damascus.

Materials and Methods: The study was conducted retrospectively over a period of 10 years, including all patients admitted to Al-Assad University Hospital in Damascus and who underwent a fair endoscopy. The number of patients in the study sample was 211 patients who underwent a mediastinoscopy procedure, and the patients were divided into two groups (A and B) according to the expected diagnosis to facilitate the study and increase the extent of objectivity.

Results: Males was 110 (52.13%) and Females was 101 (47.87%). Their ages ranged between 13 and 71 years. The median  age was 42 years. Sarcoidosis is the most common cause of mediastinal lymphadenopathy (23.7%), followed by pulmonary adenocarcinoma (19.43%). Sensitivity (98.57%), specificity (100%), false negative (1.43%) and accuracy (98.58%).

Conclusion: Mediastinoscopy is a very effective method in evaluating mediastinal lymphadenopathy a, thus avoiding the problems caused by taking small doses when relying on other investigational methods such as FNA or EUS. Although it is a surgical procedure but it is not satisfactory, has few complications, does not require a long recovery period and has sensitivity and specificity rates with high accuracy. It is recommended that mediastinoscopy be applied to all patients with mediastinal lymphadenopathy due to its high efficacy and high positivity in establishing a rapid and reliable histological diagnosis.