[Evaluation of intrathoracic lymphatic involvement: the role of mediastinoscopy]

Mediastinoscopy is a technique that allows palpating, inspecting and puncturing the lymph nodes of the upper mediastinum. When this examination is performed as a routine in patients with a supposedly operable lung cancer, the positiveness rate is 25-30% and most subjects become inoperable because of the extent of invasion. The specificity of mediastinoscopy is of 100%, and it ensures that no potentially operable patient shall be refused for curative surgery. Anterior mediastinoscopy and extensive cervical mediastinoscopy are complementary techniques, which allow exploring the anterior mediastinum in patients with a cancer of the left upper lobe. In experienced hands, these techniques are safe and cause little or no morbidity.