mediastinotomy

Mediastinoscopy
	Intervention
ICD-9-CM	34.22
MeSH	D008481
OPS-301 code:	1-691.1

縦隔切開術

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/30 14:49:24」(JST)

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Mediastinoscopy is a procedure that enables visualization of the contents of the mediastinum, usually for the purpose of obtaining a biopsy.^[1] Mediastinoscopy is often used for staging of lymph nodes of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma.

Mediastinoscopy involves making an incision approximately 1 cm above the suprasternal notch of the sternum, or breast bone. Dissection is carried out down to the pretracheal space and down to the carina. A scope (mediastinoscope) is then advanced into the created tunnel which provides a view of the mediastinum. The scope may provide direct visualization or may be attached to a video monitor.

Mediastinoscopy provides access to mediastinal lymph node levels 2, 4, and 7.

Extended mediastinoscopy

Extended mediastinoscopy is a technique which allows access to the pre-aortic (station 6) and aortopulmonary window (station 5) lymph nodes.

Parasternal mediastinotomy

Parasternal mediastinotomy, aka, a Chamberlain procedure, is the standard approach to access lymph nodes at stations 5 and 6.

References

^ Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 1853–1854. ISBN 0-07-145739-9.

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English Journal

Large thoracomyoplasty and negative pressure therapy for late postpneumonectomy empyema with a retrosternal abscess: a modern version of the Clagett procedure.

Durand M, Godbert B, Anne V, Grosdidier G.SourceDepartment of Thoracic Surgery, University Hospital Nancy, Nancy, France. durandm@me.com
Interactive cardiovascular and thoracic surgery.Interact Cardiovasc Thorac Surg.2011 May;12(5):888-9. Epub 2011 Feb 8.
A 63-year-old male with a history of cancer, and who had undergone a left pneumonectomy seven years before, presented with deterioration in his general status and recent dyspnea [stage III (New York Heart Association) NYHA]. Imaging revealed a contralateral mediastinal shift and cardiac compression
PMID 21303873

[Filling of the thymic space after chemotherapy for ovarian cancer].

Achir A, Mahdi M, Ouadnouni Y, Bouchikh M, Msougar Y, Fenane H, Ouchane F, Benosman A.SourceService de chirurgie thoracique, CHU Ibn Sina, faculte de medecine et pharmacie, universite Mohammed V, Rabat, Maroc. abdachir@yahoo.fr
Revue des maladies respiratoires.Rev Mal Respir.2010 Nov;27(9):1101-4.
INTRODUCTION: Enlargement of the thymus following remission of a cancer treated by chemotherapy poses a problem of differential diagnosis between benign thymic hyperplasia and relapse of a mediastinal tumour.CASE REPORT: We report the case of a thymic tumour developing 6 months after chemotherapy fo
PMID 21111285

Japanese Journal

巨大な原発性上皮小体腺腫の1例

井ノ上雅子,窪田哲昭,松井和夫 [他],竹村栄毅,華岡肇,内藤聡
耳鼻咽喉科臨床. 補冊 = Practica otologica. Suppl. 109, 119-123, 2002-12-10
… The tumor was excised from the neck without mediastinotomy. …
NAID 10010124312

Technetium-99m Tetrofosmin Parathyroid Imaging in Patients with Primary Hyperparathyroidism

Hiromatsu Yuji,Ishibashi Masatoshi,Nishida Hidemi [他],OKUDA Seiya,MIYAKE Ikuyo
Internal medicine 39(2), 101-106, 2000-02-01
… Patients Twenty patients with primary hyperparathyroidism were referred to our clinic, underwent surgical neck exploration or mediastinotomy and were diagnosed as having parathyroid adenoma. …
NAID 10013261356

Cost-efficacy of endoscopic ultrasonography with fine-needle aspiration vs. mediastinotomy in patients with lung cancer and suspected mediastinal adenopathy