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Fırat Tıp Dergisi
2005, Cilt 10, Sayı 2, Sayfa(lar) 064-067
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The Value of Left Anterior Mediastinotomy For Staging Left Upper Lobe Non-Small Cell Lung Cancer
Altuğ KOŞAR1, Alpay ÖRKİ1, Hakan KIRAL1, Kemal TEMÜRTÜRKAN2, Hatice ERYİĞİT1, Canan Dudu ŞENOL1
1Heybeliada Göğüs Hastalıkları ve Göğüs Cerrahi Merkezi, Göğüs Cerrahisi, İSTANBUL
1Mardin Devlet Hastanesi, Göğüs Cerrahisi, MARDİN

Objectives: Anterior mediastinotomy was commonly used for the evaluation of anterior mediastinal lymph nodes, mediastinum, pulmonary hilum and parenchym.

Materials and Methods: Left anterior mediastinotomy (LAM) was performed for the staging of left upper lobe non-small cell lung carcinoma (NSCLC) in 76 cases between 1995 and 2004 years. There were 70 male, 6 female with the median age 53.4 (23-73). Nineteen of those cases were underwent intrapericardial exploration (IPE) to evaluate the resectability.

Results: One or more than one (n=61) mediastinal tissue invasion were detected in 45 cases. Thirty-one cases, which were considered as an operable group after LAM, underwent standard cervical mediastinoscopy (SCM). Thoracotomy was performed to 26 cases, because of the detection of metastatic lymph nodes in 5 cases after SCM. Resection could not be performed because of perioperative cardiac problems in 3 and decendan aort invasion in 2 of the cases. Complete resection was achieved all the 21 cases except one. No mortality was detected. Complications were, developed local tumor recurrence on the incision scar 13 months after LAM (n=1), temporary hoarseness (n=2) and wound infection (n=2). According to our results, LAM had 100% specifity and 95.7% sensitivity.

Conclusion: LAM should be performed in the staging of left upper lobe NSCLC with SCM. The reliability of the LAM and IPE is more than 90% in order to decide the resectability. Unnecessary thoracotomies can be minimize by the method. This method can be used securely in experienced hands with low complication. ©2005, Fırat Üniversitesi, Tıp Fakültesi

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