The Evolution and Present Status of Mediastinoscopy

Abstract

Les ganglions bronchiques sont comme le mirroir du poumon"; this phrase was coined by Parrot in 1876, while speaking before the Société de Biologie in Paris on his researches on the relationship between the pathological changes in the lungs and those in the corresponding tracheo-bronchial nodes (16). He pointed out that these lesions were constant and henceforth one spoke of "la loi de adenopathies similaires" or just of "la loi de Parrot". Kiiss elaborated on this in 1898 with reference to pulmonary tuberculosis in childhood and gave the first classical description of the primary focus in the lung (le foyer pulmonaire primitif) (10), usually attributed to Anton Ghon, who wrote his book much later in 1912 (4). Tuberculosis, which was the scourge of the last century, is no longer the dreaded disease,

Complications of mediastinoscopy

“…The most serious complication is haemorrhage from one of the large vessels in the mediastinum (Foster, 1972;Nohl-Oser, 1979,1980Farrow, 1985;Luke etal., 1986). For an inexperienced surgeon it may be difficult to decide whether a mediastinal mass is a true tumour or contains some vascular structures in an abnormal position in the mediastinum.…”

Repeat Mediastinoscopy

“…As Palva [2] in his monograph on mediasti noscopy confirmed: 're-mediastinoscopies should not become frequent; the initial one should, as a rule, suffice'. Repeated media stinoscopy has been reported as inadvisable, unless it is done not later than 3-4 days after the first examination [12]. It is believed that after 7-10 days, fibrosis will be so pro nounced that the possibility of a positive finding is very slight.…”