[The importance of mediastinoscopy for accurate lymph node staging]

The mediastinoscopy (MS) was developed 1959 by Carlens. Since the introduction of computertomography (CT) in the diagnostic of the thorax the MS was no longer used routinely. Because of the introduction of the CT in our clinic we performed only 111 MS between 1981 and 1992, in contrast to 185 MS between 1976 and 1981. No patient died perioperatively. Two patients had to be operated on for bleeding. The sensitivity of the modern CT-scan for a correct preoperative staging of a bronchial carcinoma runs up to 90% and the specifity up to 85%. Therefore a correct preoperative staging can only be reached histologically with the help of a MS. An exception are T1 and T2 tumors because of only 28% mediastinal lymph node metastases. We think that the MS should be performed more often in order to reach a correct, histologically ascertained staging preoperatively.