Anesthesia in repeat mediastinoscopy: a retrospective study of 101 patients

In most medical textbooks, a mediastinoscopy is considered an absolute contraindication for a repeat mediastinoscopy. Retrospectively, perioperative data from 101 patients were evaluated in whom repeat mediastinoscopy was performed. The complication rate was 23% in 18 patients; 10% of these were directly related to the surgery. The surgical complications observed were hemorrhage, biopsy of the esophagus, paresis of a recurrent laryngeal nerve, and pneumothorax, which were all treated successfully. The patients receiving a nondepolarizing relaxant had fewer complications than patients given only a single dose of succinylcholine. In this patient population, the mortality rate was zero. This review concludes that an earlier mediastinoscopy is not necessarily an absolute contraindication for repeat mediastinoscopy.