Video Mediastinoscopy Versus Standard Mediastinoscopy

Abstract

Standard mediastinoscopy (SM) is a safe and established procedure for biopsy of masses and lymph nodes in the mediastinum. Technological advancements have led to video assisted mediastinoscopy (VAM). We evaluated the literature relating to the two techniques to determine if there is a clinical advantage to VAM over SM. Studies directly comparing VAM to SM are sparse and confined to non-randomized, retrospective cohort studies. Nonetheless, this literature suggests an advantage in number of lymph nodes biopsied, number of lymph node stations biopsied, sensitivity, specificity and diagnostic accuracy of VAM over SM. Complication rates associated with mediastinoscopy are low, and the literature does not convincingly demonstrate a safety advantage of VAM. In units where there is a teaching commitment we view VAM as a highly important tool. The enhanced perspective, increased visual field and the ability for an audience to see the operative field allows maximal utilization of training opportunities.