Cervical Mediastinoscopy and Anterior Mediastinotomy in Superior Vena Cava Obstruction

Dosios, Theodosios; Theakos, Nikolaos; Chatziantoniou, Christos

doi:10.1378/chest.128.3.1551

Cited by 49 publications

(32 citation statements)

References 25 publications

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“…Most experts still utilise cervical mediastinoscopy and anterior mediastinotomy to establish a diagnosis in patients with SVC syndrome secondary to anterior mediastinal mass lesions [5,6]. These procedures have a diagnostic yield of almost 100%, but .15% of patients suffer a major complication [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…These procedures have a diagnostic yield of almost 100%, but .15% of patients suffer a major complication [5,6]. Furthermore, patients need to be able to withstand a general anaesthetic and lie in a supine position.…”

Section: Discussionmentioning

confidence: 99%

“…An SVC syndrome secondary to an intrathoracic neoplasm is generally considered an oncological emergency that requires an expedient diagnostic evaluation and initiation of treatment [1,4]. Bronchoscopy and associated procedures have a reported diagnostic yield of .70% in this setting, whereas mediastinoscopy or mediastinotomy have a diagnostic yield of .90% [5,6]. The latter procedures are associated with a high anaesthetic risk and a relatively high complication rate, and major haemorrhage is seen in a significant percentage of cases due to high venous pressure [5,6].…”

mentioning

confidence: 99%

“…Bronchoscopy and associated procedures have a reported diagnostic yield of .70% in this setting, whereas mediastinoscopy or mediastinotomy have a diagnostic yield of .90% [5,6]. The latter procedures are associated with a high anaesthetic risk and a relatively high complication rate, and major haemorrhage is seen in a significant percentage of cases due to high venous pressure [5,6]. Moreover, associated brain oedema may complicate mediastinoscopy or mediastinotomy, as patients may experience significant discomfort in the supine position [1].…”

mentioning

confidence: 99%

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Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

Koegelenberg¹,

Bolliger²,

Plekker³

et al. 2009

European Respiratory Journal

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The yield and safety of ultrasound (US)-assisted transthoracic fine needle aspirations (TTFNA) and cutting needle biopsies (CNB) in the setting of superior vena cava (SVC) syndrome are unknown. The aims of the present prospective study were to asses the diagnostic yield and safety of US-assisted TTFNA and CNB in SVC syndrome with an associated mass lesion abutting the chest wall.Over a 3-yr period, the present authors screened 59 patients with SVC syndrome, and enrolled 25 patients who had an associated mass lesion that extended to the chest wall. US-assisted TTFNA with rapid on-site evaluation (ROSE) was performed in all cases. CNBs were performed where a provisional diagnosis of bronchogenic carcinoma could not be established, and in 57.1% of patients with bronchogenic carcinoma (limited due to safety constraints).ROSE of US-assisted TTFNA confirmed diagnostically useful material in 24 patients, and cytological diagnoses were ultimately made in all of these cases (diagnostic yield 96%). USassisted CNB had a diagnostic yield of 87.5%. Minor haemorrhage occurred in one out of 25 TTFNA and three out of 16 CNB. Neither procedure resulted in major haemorrhage nor pneumothoraces.US-assisted TTFNA and CNB have a high diagnostic yield and are safe in the setting of SVC syndrome with an associated mass lesion abutting the chest wall.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

Koegelenberg¹,

Bolliger²,

Plekker³

et al. 2009

European Respiratory Journal

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“…The differential diagnosis of mediastinal masses is broad and computed tomography (CT) scanning followed by biopsy is indicated in practically all cases [1,2,3,4,5]. Tissue is most often harvested by means of mediastinoscopy, mediastinotomy or related surgical procedures [2,3,4,5,6].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

et al. 2010

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Background: Ultrasound (US)-assisted transthoracic biopsy offers a less invasive alternative to surgical biopsy in the setting of mediastinal masses. Objectives: The aim of this 1-year prospective study was to assess the diagnostic yield and safety of a novel single-session sequential approach of US-assisted transthoracic fine-needle aspirations (TTFNA) with rapid on-site evaluation (ROSE) followed by cutting needle biopsies (CNB) performed by physicians on patients with anterosuperior mediastinal masses. Methods: US-assisted TTFNA with ROSE was performed on 45 consecutive patients (49.5 ± 27.7 years, 24 males), immediately followed by CNB where a provisional diagnosis of epithelial carcinoma or tuberculosis could not be established, provided a safety range could be assured. Results: TTFNA alone was deemed adequate by means of ROSE in 27 (60%) patients. CNB could be performed in 17 of the remaining 18. The on-site diagnosis corresponded to the final diagnosis in 26/45 (57.8%). An accurate cytological diagnosis was made in 33 (73.3%), and was more likely to be diagnostic in epithelial carcinoma and tuberculosis (28/30) than all other pathologies (5/15, p < 0.001). CNB yielded a diagnosis in 15/17 (88.2%). Overall, 42/45 patients were diagnosed by the single-session approach (93.3%). The final diagnoses included 41 neoplasms, with small cell lung cancer (n = 13) the commonest diagnosis. We observed no pneumothorax or major haemorrhage. Conclusions: A single-session sequential approach of US-assisted TTFNA with ROSE followed by CNB, where indicated, has a high diagnostic yield for anterosuperior mediastinal masses, is safe and offers an alternative to surgical biopsy.

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Superior vena cava syndrome in a child with mediastinal mass: A case report

Rijal

Shrestha

Chaudhary

et al. 2022

Clinical Case Reports

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Cervical Mediastinoscopy and Anterior Mediastinotomy in Superior Vena Cava Obstruction

Cited by 49 publications

References 25 publications

Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

Superior vena cava syndrome in a child with mediastinal mass: A case report

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