Mediastinoscopy

The Mediastinoscopy (abbr .: MSK or MESK) is an endoscopic surgery of the middle mediastinum . It is in general anesthesia (general anesthesia) by means of a special endoscope ( mediastinoscope performed). This method is therefore a so-called minimally invasive operation of the "middle area" (mediastinum) between the two lungs.

Usually the mediastinoscopy is performed nowadays as a video mediastinoscopy . In video mediastinoscopy, the operating area is shown on a monitor, which enables a better view and a magnification of up to 15 times. In classic mediastinoscopy, only the surgeon has a view of the operating area.

Indications for this surgical exploration are e.g. B. the histological examination of enlarged lymph nodes , which is carried out by means of a biopsy or a lymph node extirpation during mediastinoscopy. The diagnosis can then be made with this. This is often done in the diagnosis of lung tumors , such as non-small cell bronchial carcinoma (NSCLC), as well as to assess the tumor stage , since consequences with regard to therapy are derived from it. Other indications for mediastinoscopy are suspicion of sarcoidosis , malignant lymphoma or mesothelioma .

Mediastinoscopy is usually preceded by preliminary examinations such as chest x-ray , computed tomography (CT), magnetic resonance tomography (MRT) or positron emission tomography (PET) in order to increase the accuracy of the lymph node staging and to minimize the risk for the patient. Because although MSK has a low risk in experienced hands, injuries to vessels or nerves ( recurrent laryngeal nerve ) with resulting vocal cord paralysis or an injury to the pleura (with the development of a pneumothorax ) are possible and exist as with any invasive procedure the risk of germs and thus infection of the mediastinum ( mediastinitis ).

With extended mediastinoscopy , the examination path is extended beyond the aortic arch to the left in order to make the para- aortic lymph nodes accessible for clarification.

Web links

• Uni Münster: mediastinoscopy (procedure)

Individual evidence

1. ↑ Ärzteblatt-Sachsen-Anhalt The mediastinoscopy: technology, indications, results; Article in the Ärzteblatt Sachsen-Anhalt from March 2008

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