Parasternal Mediastinal Exploration to Evaluate Resectability of Thoracic Neoplasms

Stemmer, Edward A.; Calvin, James W.; Steedman, Robert A.; Connolly, John E.

doi:10.1016/s0003-4975(10)65138-7

Cited by 13 publications

(2 citation statements)

References 14 publications

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“…In 1965, Stemmer et al [13] used a parasternal approach for direct exploration of the mediastinal content without producing pneumothorax. They also described a parasternal mediastinoscopy method in 1971 [14]. That same year, Calvin et al [15] reported the results of 152 parasternal mediastinoscopies.…”

Section: After Larrey and Romeromentioning

confidence: 99%

First Steps in the Management of Pericardial Effusion: Who Was First to Relieve the Pericardial Sac—Larrey or Romero?

Tóth¹,

Rami–Porta

Rendeki

et al. 2013

World j. surg.

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Section: After Larrey and Romeromentioning

confidence: 99%

First Steps in the Management of Pericardial Effusion: Who Was First to Relieve the Pericardial Sac—Larrey or Romero?

Tóth¹,

Rami–Porta

Rendeki

et al. 2013

World j. surg.

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“…Having extensive experience in collar mediastinoscopy, we utilized the existing armamentarium of the Carlens procedure [16] in a Chamberlain approach in order to achieve pericardial decompression in the form of a pericardiopleural window [17-19]. …”

Section: Introductionmentioning

confidence: 99%

Mediastinoscope-controlled parasternal fenestration of the pericardium: definitive surgical palliation of malignant pericardial effusion

Tóth¹,

Szücs²,

Molnár

2012

J Cardiothorac Surg

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Background The tumorous infiltration or carcinosis of the pericardium could cause pericardial effusion in up to one-third of cases of malignancy, thus potentially interfere with the otherwise desirable oncological treatment. The existing surgical methods for the management of pericardial fluid are well-established but are not without limitations in the symptomatic relief of malignant pericardial effusion (MPE). The recurrence rate ranges between 43 and 69% after pericardiocentesis and 9 to 16% after pericardial drainage. The desire to overcome relative limitations of the existing methods led us to explore an alternative approach. Methods The standard armamentarium of the Carlens collar mediastinoscopy procedure was utilized in a Chamberlain parasternal approach of the pericardial sac. The laterality of approach was decided based upon the pleural involvement, as tumor-free pericardiopleural reflection is required. A pericardio-pleural window at least 3 cm in diameter was created. From January 2000 to December 2009, 22 cases were operated on with mediastinoscope-controlled parasternal fenestration (MCPF). Considering the type of the primary tumor, there were 11 lung cancer, 6 breast cancers, 2 haematologic malignancies and in 3 patients the origin of malignancy could not be verified. Results There were no operative deaths. We lost one patient (4.5%) in the postoperative hospital period. All of the surviving patients had a minimum of 2 months of symptom-free survival. We detected transient recurrence of MPE in one patient (4.5%) 14 days after the MCPF, which disappeared spontaneously after 24 hours. Conclusion The MCPF offers a real alternative in certain cases of pericardial effusion. We recommend this method especially for the definitive surgical palliation of MPE.

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Ultrasonography and ultrasonographically guided fine-needle aspiration biopsy of impalpable cervical lymph nodes in patients with non-small cell lung cancer

Chang

Yang

et al. 1992

Cancer

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Background. Neck ultrasonography (US) and ultrasonographically guided fine‐needle aspiration (UGFNA) cytologic examination were used in the staging work‐up of 51 consecutive patients with non‐small cell lung cancer (NSCLC) with clinically impalpable cervical lymphadenopathy. Methods. All patients had chest radiography, fiberoptic bronchoscopic examination, computed tomography (CT) scans of the chest and abdomen, bone scan, and US of the abdomen and the neck. Results. Six patients (12%) were found to have cervical lymph nodes by neck US. The cytologic examination of the lymph node aspirates obtained from UGFNA confirmed the metastasis. The clinical stage thus was changed from Stage IIIa to Stage IIIb in one patient. In the other five patients, UGFNA of cervical lymph nodes prevented more invasive diagnostic procedures. Conclusions. This preliminary study shows that neck US and UGFNA of lymph nodes may be helpful in the pretreatment evaluation of patients with NSCLC with impalpable cervical lymph nodes. However, additional study is needed to confirm this result.

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Parasternal Mediastinal Exploration to Evaluate Resectability of Thoracic Neoplasms

Cited by 13 publications

References 14 publications

First Steps in the Management of Pericardial Effusion: Who Was First to Relieve the Pericardial Sac—Larrey or Romero?

First Steps in the Management of Pericardial Effusion: Who Was First to Relieve the Pericardial Sac—Larrey or Romero?

Mediastinoscope-controlled parasternal fenestration of the pericardium: definitive surgical palliation of malignant pericardial effusion

Ultrasonography and ultrasonographically guided fine-needle aspiration biopsy of impalpable cervical lymph nodes in patients with non-small cell lung cancer

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