What is the role of mediastinoscopy in the workup of secondary lung cancer?

Updated: Feb 08, 2019
  • Author: Daniel S Schwartz, MD, MBA, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Mediastinoscopy is the criterion standard for the diagnosis of mediastinal lymph node metastatic disease. Reported specificity of the procedure is as high as 100%, with a sensitivity of approximately 90%.

Cervical mediastinoscopy by the Carlens method is used for the diagnosis of right-side paratracheal, precarinal, and subcarinal lymphadenopathy. Left-side parasternal mediastinoscopy is used for the diagnosis of anterior mediastinal and aortopulmonary window lymph node metastases.

Mediastinoscopy is an outpatient procedure with a reported complication rate of 2% and a procedure-related mortality of 0.2%.


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