A procedure that enables visualization of the contents of the mediastinum, usually for the purpose of obtaining a biopsy.

Often used for staging of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma.

Involves making an incision approximately 1 cm above the suprasternal notch of the sternum.

Dissection is carried out down to the pretracheal space and carina, and a mediastinoscope is then advanced into the created tunnel allowing a view of the mediastinum.

Mediastinoscopy provides access to mediastinal lymph node levels 2, 4, and 7, and an extended mediastinoscopy allows access to the pre-aortic and aortopulmonary window lymph nodes, at stations 6, and 5, respectively.

The Chamberlain procedure, parasternal mediastinotomy, allows approach to lymph nodes at stations 5 and 6.

Requires general anesthesia and has a morbidity of 1% and a mortality of 0.2%.

In a study of cases from 1968 to 1987, mediastinoscopy was performed on 2021 consecutive patients: Biopsy was positive in 54 per cent of the cases, and total number of complications was 2.3 per cent (Puhakka HJ).

Complications in the above study include: four cases with major hemorrhage, three tracheal ruptures and three wound infections, recurrent nerve paralysis was verified in three patients and pericardial rupture in two patients.

The total of major complications was 0.5 per cent with no deaths in this series.

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