The Diagnostic Efficiency of the Use of Non-Standard Surgical Instruments in Mediastinoscopy

Abstract

Introduction:Mediastinoscopy is an effective diagnostic method used in the diagnosing of benign granulomatous diseases and for lung cancer staging. However, the success of this method is directly proportional to the amount of pathological material taken. This study aimed to compare the diagnostic efficiency of the diagnostic superiority of the use of standard surgical instruments (SSI) and non-standard surgical instruments (NSSI) in mediastinoscopy in patients with mediastinal lymph nodes, which are thought to be pathological, according to different diseases.Methods:One hundred and seven patients who underwent mediastinoscopy were divided into two groups according to the use of SSI (n=89) and NSSI (n=18). Analysis was made of age, gender, pre-diagnosis, fluorodeoxyglucose-positron emission tomography and substance uptake values of the groups, pathology if endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) had been performed, operation notes (use of video mediastinoscope, use of SSI or NSSI, sampled mediastinal lymph node stations), complications and pathology results analyzed.Results:The use of NSSI was found to be statistically significantly higher in patients with previous EBUS-TBNA (p=0.013), in operations in which a single mediastinal station was sampled (p=0.004), and in cases where the pathological diagnosis was tuberculosis (TB) (p<0.001). A tissue with diagnostic value was sampled in all patients who needed NSSI were used in mediastinoscopy, no complications were observed, and TB was diagnosed at a rate of 60% (p=0.013).Conclusion:The use of NSSI, such as long and thin mediastinoscopy aspirator and forceps, endoscopic scissors, injection needles, and endoclip in addition to SSI in mediastinoscopy increase the success of diagnosing TB.

Keywords

• mediastinoscopy
• non-standard surgical instruments
• invasive staging
• tuberculosis