[Is mediastinoscopy a necessary preoperative procedure in non-small cell lung cancer?].

Background And Methods: Over the decade 1990 to 2000, our hospital performed 149 mediastinoscopies in order to support CT scans in the staging on mediastinal lymph nodes in non-small cell lung cancer.

Results: CT scans indicated N0-N1 tumours in 64 patients; mediastinoscopy showed that eight of these had N2 disease. Another seven N2 tumours were found in the postoperative histological diagnosis. N2 tumours were indicated by CT scans in 79 patients. Mediastinoscopy proved 53 of these to be N0-N1 tumours; 46 cases were operated, 33 proved to be N0-N1. N3 tumours were indicated by CT scans in six patients. Mediastinoscopy proved this wrong in establishing that three had N0, which was confirmed in the postoperative findings.

Interpretation: Only one serious bleeding occurred in a total of 193 mediastinoscopies over the ten-year period. No other complications were reported, hence our material shows that mediastinoscopy is a fairly safe procedure. It is a necessary diagnostic supplement when N2 and N3 tumours are found by CT scan. The benefit of mediastinoscopy is more uncertain when the CT findings are N0-N1 tumours.