Is mediastinoscopy an effective diagnostic method in mediastinal area evaluation in pediatric patients?

Abstract

Summary: Background: The purpose of the study was to discuss the effectiveness of mediastinoscopy for pediatric patients as the use of EBUS–EUS (Endobronchial Ultrasound-Endoscopic Ultrasound) has replaced mediastinoscopy for adult patients in evaluation of the mediastinal area. Methods: The records of patients subject to cervical and anterior mediastinoscopy at our clinic from January 1, 2000 to June 1, 2019 were examined and patients aged 18 years or less were included in the study. Data were acquired on the demographic characteristics of the patients, type of surgery, complications, operation times, and histopathologic diagnoses. Results: Of the 1505 patients subject to intervention by mediastinoscopy at our clinic from January 1, 2000 to June 1, 2019, only 22 (1.46%) were pediatric patients aged 18 years or less. Cervical and anterior mediastinoscopies were performed on 16 and six patients, respectively. Histopathological tissue diagnoses via mediastinoscopy were obtained for 19 (86.3%) of 22 patients. The most frequently observed diagnoses were sarcoidosis (n = 10), lymphoma (n = 4), thymoma (n = 1), tuberculosis (n = 1), undifferentiated round cell sarcoma (n = 1), and reactive lymph node (n = 2); three patients could not be diagnosed. Mortality was not detected. There were no major complications requiring thoracotomy or sternotomy and none of the patients were subject to tube thoracostomy as a result of surgery. Conclusion: Pediatric age mediastinoscopy may be the first method of diagnosis due to low complication rates and high diagnosis rates in mediastinal area.

Keywords

• Mediastinoscopy
• Paratracheal lymphadenopathy
• Paratracheal mass
• Pediatric surgery