[Complications following mediastinoscopy. Prevention and therapy]

Mediastinoscopy, being practised since 20 years, is a research method giving a high degree of information and during this time has become indispensable in diagnosis of diseases of the chest. The close neighbourhood of vital organs, small and easily vulnerable blood vessels and nerval tissues of functional importance first seemed to burden this method of investigation with an incalculate risk. But subtle operative technique with its instruments by Carlens and others let the number of complications remain remarkably small even in great collective statistics. The number of lethal complications ranged below 0.2%, more severe ones about 1%. But in these latter ones one almost always succeeds in achieving a restitutio ad integrum bei performance of consequent after-treatment. The more frequent mediastinoscopic investigations are performed in regions of marked pathologic changes, the higher is the number of described complications. But it must be considered that in many cases the more perilous and functionally straining thoracotomy can be avoided using mediastinoscopy. Complications occurring most frequently are described and possibilities of therapy are discussed.