No abstract available.
Mediastinoscopy*

The extent of resection and release of the trachea is important for successful anastomosis. Bilateral bronchial dissection is one of the release techniques for resection of the lower trachea. We present the experience of cervical video-assisted mediastinoscopic bilateral bronchial release for long segmental resection and anastomosis of the lower trachea.
Mediastinoscopy ; Trachea

No abstract available.
Carcinoma, Bronchogenic* ; Lymph Nodes* ; Mediastinoscopy*

Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.
Bronchogenic Cyst ; Humans ; Mediastinal Diseases ; Mediastinoscopy ; Mediastinum

BACKGROUND: Lumbar Sympathectomy is a surgery for plantar hyperhidrosis, vascular and other reflex sympathetic diseases and has a various indications and physiologic effects. However it is not performed actively compared to thoracic sympathectomy because of its invasiveness. Therefore, we tried to perform lumbar sympathectomy using mediastinoscopy with small incision and introduce this new surgical technique. MATERIAL AND METHOD: From July 2003 to December 2004, 18 patients underwent lumbar sympathectomy with mediastinoscopy at Inje University Sanggye Paik Hospital. There were 12 males and 6 females whose mean age was 24.3+/-8.2 years ranging from 18 to 67. 30 cases of lumbar sympathectomy was performed with mediastinoscopy of which 24 cases were for plantar hyperhidrosis and 6 cases for other diseases. RESULT: Mean operation time was 37.2+/-12.5 minutes and mean post operation hospital stay was 3.1+/-2.2 days. There was one post sympathetic neuralgia and one peritoneal opening. CONCLUSION: Lumbar sympathectomy using mediastinoscopy is a simple and effective technique and has the advantage of cosmetics, post operative pain and hospital stay. However, further studies with large number of cases should be carried out for better outcome.
Female ; Humans ; Hyperhidrosis ; Length of Stay ; Male ; Mediastinoscopy ; Neuralgia ; Reflex ; Sympathectomy*

There are many causes of prolonged postoperative muscle weakness, including drugs, residual anesthetics, cerebrovascular events, electrolyte imbalance, hypothermia, and neuromuscular disease. Neuromuscular diseases are relatively rare, with the most common being myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS). We report an unusual case in which a patient who was given a muscle relaxant during mediastinoscopy developed postoperative muscle weakness that was ultimately diagnosed as secondary to LEMS.
Anesthetics ; Humans ; Hypothermia ; Lambert-Eaton Myasthenic Syndrome ; Mediastinoscopy ; Muscle Weakness ; Muscles ; Myasthenia Gravis ; Neuromuscular Diseases

BACKGROUND: Video-thoracoscopy is known to be an useful method to provide accurate pre-resectional staging in patients with lung cancer in addition to the conventional radiologic studies and mediastinoscopy, for the pleural cavity is inspected directly and biopsy specimens can be obtained. This study is undertaken to evaluate how video-thoracoscopy can be used in deciding pre-resectional stage. MATERIAL AND METHOD: Video-thoracoscopy was performed in patients with lung cancer who were scheduled for surgical resection based on the radiologic staging and mediastinoscopic biopsy. 37 patients were included in this study. Pre-thoracoscopically 18 cases were in TNM stage 1, 7 in stage 2, and 12 in stage 3. RESULT: In 15 of 37 cases, video-thoracoscopy could not be performed effectively due to heavy adhesions in the pleural cavity, diaphragmatic and chest wall invasion of tumor and bulky tumor mass es. Mediastinal lymph nodes were positive postresectionally in 6 of these 15 cases. In 22 cases, video-thoracoscopy was performed as usual. Positive mediastinal lymph nodes were identified in 2 cases and exploratory thoracotomy was prevented. Surgical resection were carried out in remaining 20 cases and 5 cases among them had positive mediastinal lymph nodes. CONCLUSION: We believe that it is difficult to perform pre-thoracotomy video-thoracoscopy for all lung cancer patients for there were many cases that thoracoscopy could not be undertaken due to heavy adhesions in the pleural cavity, tumor involvement of the chest wall and/or diaphragm and bulky tumor mass. However we think it is helpful in preventing unnecessary exploratory thoracotomy for some patients with lung cancer whom pre-thoracotomy video-thoracoscopy was carried out.
Biopsy ; Diaphragm ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Mediastinoscopy ; Pleural Cavity ; Thoracic Wall ; Thoracoscopy ; Thoracotomy

Biopsy, using mediastinoscopy is commonly employed for accurate histologic diagnosis of a mediastinal mass. However, since the mass is not removed during the procedure, it may cause compression of vital structures such as major airways, the heart, the pulmonary artery, and the superior vena cava after surgery. We observed a case of a 66-year-old man with a mediastinal mass that caused severe airway obstruction during recovery from anesthesia following mediastinoscopic biopsy, probably caused by upper airway edema which seemed to originate from compression of the superior vena cava. Therefore, we suggest that unexpected airway obstruction in a patient with a mediastinal mass can be due to superior vena cava compression.
Aged ; Airway Obstruction ; Anesthesia ; Biopsy ; Edema ; Heart ; Humans ; Mediastinoscopy ; Pulmonary Artery ; Vena Cava, Superior

OBJECTIVETo determine the current role of mediastinoscopy in the diagnosis and differential diagnosis of stage I thoracic sarcoidosis.

METHODSThe clinical data of 60 patients with a presumptive diagnosis of stage I thoracic sarcoidosis underwent mediastinoscopy from November 1999 to June 2007 were analyzed retrospectively. All the patients had hilum of lung and/or mediastinal lymphadenopathy with normal lung parenchyma on thoracic CT scan. Typical stage I sarcoidosis was defined as presence of bilateral hilum of lung lymphadenopathy with/without mediastinal lymphadenopathy.

RESULTSAll the patients had definitive pathologic diagnosis. Among the 33 patients with typical presentation of stage I sarcoidosis, 32 patients were confirmed by pathology. One patient was reactive lymph node. Among the 27 patients with atypical patterns on CT, 17 patients were confirmed by pathology. No postoperative complication and mortality occurred.

CONCLUSIONFor the patient with a presumptive diagnosis of typical stage I thoracic sarcoidosis after clinical and radiological evaluation, confirmation of the diagnosis by mediastinoscopy and lymph node biopsy is unwarranted.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Mediastinoscopy ; Middle Aged ; Retrospective Studies ; Sarcoidosis ; diagnosis

Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.
Adrenal Medulla ; Chromaffin Cells ; Headache ; Humans ; Mediastinoscopy ; Mediastinum ; Neuroendocrine Tumors ; Paraganglioma ; Pheochromocytoma ; Thorax ; Voice