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Is mediastinoscopy an effective diagnostic method in mediastinal area evaluation in pediatric patients?
1Department of Thoracic Surgery, Faculty of Medicine, University of Erciyes, Kayseri, Turkey.
Insights
Mediastinoscopy remains effective for pediatric patients, offering high diagnostic rates with minimal complications. This procedure is a valuable tool for evaluating the mediastinal area in children.
Area of Science:
- Pediatric Thoracic Surgery
- Diagnostic Procedures
- Mediastinal Pathology
Background:
- Endobronchial Ultrasound-Endoscopic Ultrasound (EBUS-EUS) is now standard for adult mediastinal evaluation.
- Mediastinoscopy's role in pediatric patients requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness and safety of mediastinoscopy in pediatric patients.
- To assess the diagnostic yield and complication rates of mediastinoscopy in individuals aged 18 years or less.
Main Methods:
- Retrospective review of pediatric patients (≤18 years) who underwent cervical or anterior mediastinoscopy between January 2000 and June 2019.
- Data collected included demographics, surgical details, complications, operation times, and histopathologic diagnoses.
Main Results:
- Only 22 (1.46%) of 1505 mediastinoscopies were performed on pediatric patients.
- Histopathological diagnoses were achieved in 86.3% of pediatric cases, with sarcoidosis and lymphoma being most common.
- No mortality or major complications requiring further surgery were reported.
Conclusions:
- Mediastinoscopy demonstrates a low complication rate and high diagnostic yield in pediatric patients.
- It can be considered a primary diagnostic method for mediastinal conditions in children.
Background:
The purpose of the study was to discuss the effectiveness of mediastinoscopy for pediatric patients as the use of EBUS-EUS (Endobronchial Ultrasound-Endoscopic Ultrasound) has replaced mediastinoscopy for adult patients in evaluation of the mediastinal area.
Methods:
The records of patients subject to cervical and anterior mediastinoscopy at our clinic from January 1, 2000 to June 1, 2019 were examined and patients aged 18 years or less were included in the study. Data were acquired on the demographic characteristics of the patients, type of surgery, complications, operation times, and histopathologic diagnoses.
Results:
Of the 1505 patients subject to intervention by mediastinoscopy at our clinic from January 1, 2000 to June 1, 2019, only 22 (1.46%) were pediatric patients aged 18 years or less. Cervical and anterior mediastinoscopies were performed on 16 and six patients, respectively. Histopathological tissue diagnoses via mediastinoscopy were obtained for 19 (86.3%) of 22 patients. The most frequently observed diagnoses were sarcoidosis (n = 10), lymphoma (n = 4), thymoma (n = 1), tuberculosis (n = 1), undifferentiated round cell sarcoma (n = 1), and reactive lymph node (n = 2); three patients could not be diagnosed. Mortality was not detected. There were no major complications requiring thoracotomy or sternotomy and none of the patients were subject to tube thoracostomy as a result of surgery.
Conclusion:
Pediatric age mediastinoscopy may be the first method of diagnosis due to low complication rates and high diagnosis rates in mediastinal area.
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