Prevention of a phrenic nerve palsy following left anterior mediastinotomy

A left phrenic nerve palsy was observed following left anterior mediastinotomy performed for staging of a left upper lobe tumour. Since no evidence of mediastinal spread of the tumour was found, a left upper lobectomy was subsequently performed. Oedema (but no evidence of tumour) was seen around the phrenic nerve in the region of the previous mediastinotomy. As a result of this experience we have altered our technique of left anterior mediastinotomy.