%0 Journal Article
%T Mediastinoscopy and More
%A Akif Turna
%J Journal of Clinical and Analytical Medicine
%D 2012
%I Derman Medical Publishing
%R 10.4328
%X Mediastinal lymph nodes are of great importance in surgically resectable non-small cell lung cancer patients and resectional surgery in N2 patients has been proven to be futile. Mediastinoscopy still remains gold standard despite the improvements in computerized tomography, PET-CT, introduction of Endobronchial Ultrasonography guided Transbronchial Needle Aspiration (EBUS-TBNA). EBUS-TBNA has been defined as a non-invasive and effective method for mediastinal lymph node staging. However, the falsenegativity of the technique seemed to increase with probability of N2 disease. The method is feasible in patients with low N2 frequency. The morbidity of the procedure is very low and the morbidity is nearly nil. Extended mediastinoscopy is another technique to evaluate the anterior mediastinal lymph nodes.. Remediastinoscopy (repeat mediastinoscopy) is theoretically feasible procedure for the evaluation of the patients who had previously proven me-diastinal lymph node involvement and received neoadjuvant therapy. However, it is usually suboptimally done due to the fibrous adhesions caused by previous intervention. New methods such as video-assisted mediastinoscopic lymphadectomy (VAMLA) and Transcervical extended mediastinal lymphadectomy (TEMLA) are lymph node dissection methods that remove all accessible lymph nodes and aim to reach 100% of accuracy. In conclusion, mediastinoscopy can be deemed as a gold standard method for evaluation of mediastinal involvement in patients with mediastinal tumor and non-small cell lung cancer. TEMLA and VAMLA as methods for total lymphadenectomy seem promising and will be considered more in future.
%K Mediastinoscopy
%K Mediastinal Staging
%K EBUS-TBNA
%U http://www.jcam.com.tr/files/KATD-598.pdf