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TANISAL MEDİASTİNOSKOPİ: 145 OLGUNUN ANALİZİ

Yıl 2010, Cilt: 24 Sayı: 1, 37 - 43, 01.05.2010

Öz

Bu çalışmada, diğer tanısal yöntemlerle tanı konulamamış mediastinal lenfadenomegali veya mediastinal lezyonu bulunan 145 olguda mediastinoskopik girişimin tanısal etkinliği retrospektif olarak incelendi. Ocak 2000ÐMart 2008 tarihleri arasında mediastinal kitle veya multipl mediastinal lenfadenomegali tanısıyla 145 olguya (74 erkek, 71 kadın; yaş ort. 42.6; dağılım 17-78) genel anestezi altında, standart servikal yaklaşımla, mediastinoskopi veya videomediastinoskopi uygulandı. Diğer noninvaziv ve invaziv yöntemlerle tanı konulamayan 145 olgunun 124 sında (%85.5) mediastinoskopi ile tanı konuldu. Histopatolojik incelemede, 64 olguda (%44.1) kronik granülomat öz lenfadenit, 25 olguda (%17.2) nonnekrotizan granülomatöz lenfadenit, 21 olguda (%14.4) reaktif lenf nodu hiperplazisi, 14 olguda (%9.6) metastatik lenf nodu, 12 olguda (%8,2) lenfoma, 6 olguda (%4.1) küçük hücreli akciğer kanseri (1 tanesi kitleden örnekleme), 2 olguda (%1.3) timoma, 1 olguda (%0.6) atipik karsinoid tümör (kitleden örnekleme) saptandı. Çalışmamız, noninvaziv ve invaziv yöntemlerle tanısı konulamayan mediastinal lenfadenopatilerde veya mediastinal solid kitlelerde, mediastinoskopinin, etkili bir tanısal yöntem olduğu yönündeki görüşleri desteklemektedir.

Kaynakça

  • 1. Kirby T, Fell S. Mediastinoscopy. In: Pearson FG, Cooper JD, Deslauriers J, Ginsberg R, Hiebert C, Patterson GA, Urschel H, editors. Thoracic surgery. New York: Churchill Livingstone; 2002. p. 98-103.
  • 2. Carlens E. Mediastinoscopy: a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest 1959; 36: 343-52.
  • 3. Ricci C, Rendina EA, Venuta F, Pescarmona EO, Di Tolla R, Ruco LP, et al. Surgical approach to isolated mediastinal lymphoma. J Thorac Cardiovasc Surg 1990; 99: 691-5.
  • 4. Tastepe ‹, Kaya S, Dogan R, Soysal Ö, Ünlü M, Çetin G. Mediastinoskopi ve mediastinotominin tan› de¤eri. Turkiye Klinikleri J Int Med Sci 1989; 7: 206-9.
  • 5. Pattison CW, Westaby S, Wetter A, Townsend ER. Mediastinoscopy in the investigation of primary mediastinal lymphadenopathy. Scand J Thorac Cardiovasc Surg 1989; 23: 177-9.
  • 6. Porte H, Roumilhac D, Eraldi L, Cordonnier C, Puech P, Wurtz A. The role of mediastinoscopy in the diagnosis of mediastinal lymphadenopathy. Eur J Cardiothorac Surg 1998; 13: 196-9.
  • 7. Shields, Thomas W, LoCicero, Joseph, Ponn, Ronald B, Rusch, Valerie W. General Thoracic Surgery, 6th Edition. Chapter 167 - Diagnostic Investigation of Mediastinal Masses. P.2498.
  • 8. Liu X, Zhang D, Lin D, Zhao J, Wang L. The role of mediastinoscopy for the diagnosis of mediastinal tuberculous lymphadenopathy and sarcoidosis. Zhonghua Jie He He Hu Xi Za Zhi 1999; 22: 156-8.
  • 9. Maassen W, Greschuchna O. Dic endoskopische und bioptische untersuchung des Media stinums. Atemwegs-u. Lungen kr. 1975; 161-6.
  • 10. Truedson H, Stjenberg N, Thumell M. Scalene lymph node biopsy: a diagnostic method in sarcoidosis. Acta ChirScand 1985; 151: 121.
  • 11. Sarin CL, Nohl-Oser HC: Mediastinoscopy. Thorax 1969; 24: 585.
  • 12. Callejas Perez MA, et al. Contribution of transcervical mediastinoscopy and anterior mediastinostomy to the diagnosis of mediastinal lymphomas. Anales de Medicina Interna 1993; 10: 228-31.
  • 13. Maassen W. Ergebnisse und Bedeutung der Mediastinoskopio und anderer thoraxbioptischer Verfahren. Springer, Berlin, 1967.
  • 14. Mjasson W, Kirsch M, Thümmler M. Indikattionen und vorlaeufige Ergebnisse bei 300 Mediastinoskopien. Prax Pneumol 1964; 18: 65.
  • 15. Moller DR. Systemic sarcoidosis. In: Fishman AP, editor. Fishman’s pulmonary diseases and disorders. 3rd ed. New York: McGraw-Hill; 1998. p. 1055-68.
  • 16. Lincoln JC, Provan JL. Mediastinoscopy in the diagnosis of nonmalignant thoracic disease. J Thorac Cardiovasc Surg 1970; 60: 144-8.
  • 17. Vallieres E, Page A, Verdant A. Ambulatory mediastinoscopy and anterior ediastinotomy. Ann Thorac Surg 1991; 52: 1122-6.
  • 18. Ferguson MK, Lee E, Skinner DB, Little AG. Selective operative approach for diagnosis and treatment of anterior mediastinal masses. Ann Thorac Surg 1987; 44: 583-6.
  • 19. Bocage JP, Mackenzie JW, Nosher JL. Invasive diagnostic procedures. In Shields TW, LoCicero J, Ponn RB. General Thoracic Surgery. Vol 1. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 273-348.
  • 20. Toker A, Kalayc› G. Akci¤er kanserinde mediastinoskopinin rolü. Toraks Dergisi 2001; 2: 72-6.
  • 21. Jolly PC, Hill LD 3rd, Lawless PA, West TL. Parasternal mediastinotomy and mediastinoscopy. Adjuncts in the diagnosis of chest disease. J Thorac Cardiovasc Surg 1973; 66: 549-6.
  • 22. Davis RD, Oldham HN, Sabiston DC. The mediastinum. In: Sabiston DC, Spencer FC, editors. Surgery of the chest. 5th ed. Philadelphia: W.B. Saunders Company; 1990. p. 498-535.
  • 23. Azarow KS, Pearl RH, Zurcher R, Edwards FH, Cohen AJ. Primary mediastinal masses. A comparison of adult and pediatric populations. J Thorac Cardiovasc Surg 1993; 106: 67-72.
  • 24. Specht G: Discussion by Carlens. in Jepsen O, Sorenson HR (eds): Mediastinoscopy. Denmark: Odunsa Univercity Press, 1971; pp. 130.
  • 25. Ginsberg RJ: Evaluation of the mediastinum by invasive techniques. Surg Clin North Am 1987; 67: 1025-15.
  • 26. Coldstraw P: Mediastinal exploration by mediastinoscopy and mediastinotomy. Br J Dis Chest 1988; 82: 11-20.
  • 27. Cybulsky IJ, Bennett F: Mediastinoscopy as a routine outpatient procedure. Ann Thorac Surg 1994; 58: 176-8.
  • 28. Liu X Zhong D Zhoq R. Clinical value of mediastinoscopy in the diagnosis of mediastinal mass: an analysis of 60 cases. Zhonghua Zhong Liu Za Zhi 2000; 22: 238-40.
  • 29. Demircan S, Kurul ‹C, Kürkçüo¤lu ‹C, Yorganc›lar D. The Results of Diagnostic Mediastinoscopy: Analyses of 30 cases. Turkish Journal of Thoracic and Cardiovascular Surgery 2006; 14: 295-8.
  • 30. Pakhale SS, Unruh H. Tan L. Sharma S. Has mediastinoscopy still a role in suspected stage I sarcoidosis? Sarcoidosis Vasc Diffuse Lung Dis 2006; 23: 66-9.
  • 31. Hsu HS, Wang LS, Hsieh CC, Wang CY, Wu YC, Huang BS, et al. The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. J Chin Med Assoc 2003; 66: 231-5.
  • 32. Gürses A. Mediastinoscopy. Turkiye Klinikleri J Int Med Sci 2006; 2: 53-6.
  • 33. Deslauriers J, Letourneau L, Giubilei G. Tumors and masses: diagnostic strategies in mediastinal tumors and masses. In: Pearson FG, Cooper JD, Deslauriers J, Ginsberg RJ, Hiebert CA, Patterson GA, et al, editors. Thoracic surgery. Vol. 2, 2nd ed. New York: Churchill Livingston; 2002. p. 1655-73

THE RESULTS OF DIAGNOSTIC MEDIASTINOSCOPY: ANALYSES OF 145 CASES

Yıl 2010, Cilt: 24 Sayı: 1, 37 - 43, 01.05.2010

Öz

One hundred forty five patie nts with mediastinal lesions which could not be diagnosed with other diagnostic techniques, have been retrospectively rewieved in order to retrospectively evaluate the results of diagnosis objected mediastinoscopy. One hundred forty five patients (74 males, 71 females; mean age 42.6 years; range 17 to 78 years) with mediastinal mass underwent diagnostic mediastinoscopy under general anesthesia by the same surgical team by standard cervical approach, between Jan 2000 and March 2008. According to the histopathological examination, 64 patients (44.1%) had chronic granulomatous, 25 patients (17.2%) had non-necrotizing granulomatous, 21 patients (14.4%) had reactive lymph node hyperplasia, 14 patients (9.6%) had metastatic disease, 12 patients (8.2%) had lymphoma, 6 patients (4.1%) had metastatic lymph node due to small cell ca, 2 patients (1.3%) had thymoma and 1 patients (0.6%) had atypic carcinoid tumour. Our results support the view that mediastinoscopy is a useful method in patients with mediastinal lesions which could not be diagnosed with less invasive or non-invasive diagnostic techniques.

Kaynakça

  • 1. Kirby T, Fell S. Mediastinoscopy. In: Pearson FG, Cooper JD, Deslauriers J, Ginsberg R, Hiebert C, Patterson GA, Urschel H, editors. Thoracic surgery. New York: Churchill Livingstone; 2002. p. 98-103.
  • 2. Carlens E. Mediastinoscopy: a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest 1959; 36: 343-52.
  • 3. Ricci C, Rendina EA, Venuta F, Pescarmona EO, Di Tolla R, Ruco LP, et al. Surgical approach to isolated mediastinal lymphoma. J Thorac Cardiovasc Surg 1990; 99: 691-5.
  • 4. Tastepe ‹, Kaya S, Dogan R, Soysal Ö, Ünlü M, Çetin G. Mediastinoskopi ve mediastinotominin tan› de¤eri. Turkiye Klinikleri J Int Med Sci 1989; 7: 206-9.
  • 5. Pattison CW, Westaby S, Wetter A, Townsend ER. Mediastinoscopy in the investigation of primary mediastinal lymphadenopathy. Scand J Thorac Cardiovasc Surg 1989; 23: 177-9.
  • 6. Porte H, Roumilhac D, Eraldi L, Cordonnier C, Puech P, Wurtz A. The role of mediastinoscopy in the diagnosis of mediastinal lymphadenopathy. Eur J Cardiothorac Surg 1998; 13: 196-9.
  • 7. Shields, Thomas W, LoCicero, Joseph, Ponn, Ronald B, Rusch, Valerie W. General Thoracic Surgery, 6th Edition. Chapter 167 - Diagnostic Investigation of Mediastinal Masses. P.2498.
  • 8. Liu X, Zhang D, Lin D, Zhao J, Wang L. The role of mediastinoscopy for the diagnosis of mediastinal tuberculous lymphadenopathy and sarcoidosis. Zhonghua Jie He He Hu Xi Za Zhi 1999; 22: 156-8.
  • 9. Maassen W, Greschuchna O. Dic endoskopische und bioptische untersuchung des Media stinums. Atemwegs-u. Lungen kr. 1975; 161-6.
  • 10. Truedson H, Stjenberg N, Thumell M. Scalene lymph node biopsy: a diagnostic method in sarcoidosis. Acta ChirScand 1985; 151: 121.
  • 11. Sarin CL, Nohl-Oser HC: Mediastinoscopy. Thorax 1969; 24: 585.
  • 12. Callejas Perez MA, et al. Contribution of transcervical mediastinoscopy and anterior mediastinostomy to the diagnosis of mediastinal lymphomas. Anales de Medicina Interna 1993; 10: 228-31.
  • 13. Maassen W. Ergebnisse und Bedeutung der Mediastinoskopio und anderer thoraxbioptischer Verfahren. Springer, Berlin, 1967.
  • 14. Mjasson W, Kirsch M, Thümmler M. Indikattionen und vorlaeufige Ergebnisse bei 300 Mediastinoskopien. Prax Pneumol 1964; 18: 65.
  • 15. Moller DR. Systemic sarcoidosis. In: Fishman AP, editor. Fishman’s pulmonary diseases and disorders. 3rd ed. New York: McGraw-Hill; 1998. p. 1055-68.
  • 16. Lincoln JC, Provan JL. Mediastinoscopy in the diagnosis of nonmalignant thoracic disease. J Thorac Cardiovasc Surg 1970; 60: 144-8.
  • 17. Vallieres E, Page A, Verdant A. Ambulatory mediastinoscopy and anterior ediastinotomy. Ann Thorac Surg 1991; 52: 1122-6.
  • 18. Ferguson MK, Lee E, Skinner DB, Little AG. Selective operative approach for diagnosis and treatment of anterior mediastinal masses. Ann Thorac Surg 1987; 44: 583-6.
  • 19. Bocage JP, Mackenzie JW, Nosher JL. Invasive diagnostic procedures. In Shields TW, LoCicero J, Ponn RB. General Thoracic Surgery. Vol 1. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 273-348.
  • 20. Toker A, Kalayc› G. Akci¤er kanserinde mediastinoskopinin rolü. Toraks Dergisi 2001; 2: 72-6.
  • 21. Jolly PC, Hill LD 3rd, Lawless PA, West TL. Parasternal mediastinotomy and mediastinoscopy. Adjuncts in the diagnosis of chest disease. J Thorac Cardiovasc Surg 1973; 66: 549-6.
  • 22. Davis RD, Oldham HN, Sabiston DC. The mediastinum. In: Sabiston DC, Spencer FC, editors. Surgery of the chest. 5th ed. Philadelphia: W.B. Saunders Company; 1990. p. 498-535.
  • 23. Azarow KS, Pearl RH, Zurcher R, Edwards FH, Cohen AJ. Primary mediastinal masses. A comparison of adult and pediatric populations. J Thorac Cardiovasc Surg 1993; 106: 67-72.
  • 24. Specht G: Discussion by Carlens. in Jepsen O, Sorenson HR (eds): Mediastinoscopy. Denmark: Odunsa Univercity Press, 1971; pp. 130.
  • 25. Ginsberg RJ: Evaluation of the mediastinum by invasive techniques. Surg Clin North Am 1987; 67: 1025-15.
  • 26. Coldstraw P: Mediastinal exploration by mediastinoscopy and mediastinotomy. Br J Dis Chest 1988; 82: 11-20.
  • 27. Cybulsky IJ, Bennett F: Mediastinoscopy as a routine outpatient procedure. Ann Thorac Surg 1994; 58: 176-8.
  • 28. Liu X Zhong D Zhoq R. Clinical value of mediastinoscopy in the diagnosis of mediastinal mass: an analysis of 60 cases. Zhonghua Zhong Liu Za Zhi 2000; 22: 238-40.
  • 29. Demircan S, Kurul ‹C, Kürkçüo¤lu ‹C, Yorganc›lar D. The Results of Diagnostic Mediastinoscopy: Analyses of 30 cases. Turkish Journal of Thoracic and Cardiovascular Surgery 2006; 14: 295-8.
  • 30. Pakhale SS, Unruh H. Tan L. Sharma S. Has mediastinoscopy still a role in suspected stage I sarcoidosis? Sarcoidosis Vasc Diffuse Lung Dis 2006; 23: 66-9.
  • 31. Hsu HS, Wang LS, Hsieh CC, Wang CY, Wu YC, Huang BS, et al. The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer. J Chin Med Assoc 2003; 66: 231-5.
  • 32. Gürses A. Mediastinoscopy. Turkiye Klinikleri J Int Med Sci 2006; 2: 53-6.
  • 33. Deslauriers J, Letourneau L, Giubilei G. Tumors and masses: diagnostic strategies in mediastinal tumors and masses. In: Pearson FG, Cooper JD, Deslauriers J, Ginsberg RJ, Hiebert CA, Patterson GA, et al, editors. Thoracic surgery. Vol. 2, 2nd ed. New York: Churchill Livingston; 2002. p. 1655-73
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA88FB74FA
Bölüm Araştırma Makalesi
Yazarlar

Atilla Pekçolaklar Bu kişi benim

Necati Çitak Bu kişi benim

Muzaffer Metin Bu kişi benim

Adnan Sayar Bu kişi benim

Alper Çelikten Bu kişi benim

Abdülaziz Kök Bu kişi benim

Atilla Gürses Bu kişi benim

Yayımlanma Tarihi 1 Mayıs 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 24 Sayı: 1

Kaynak Göster

APA Pekçolaklar, A., Çitak, N., Metin, M., Sayar, A., vd. (2010). TANISAL MEDİASTİNOSKOPİ: 145 OLGUNUN ANALİZİ. İzmir Göğüs Hastanesi Dergisi, 24(1), 37-43.