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European Journal of Cardio-Thoracic Surgery, Vol 11, 218-221, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

Ambulatory mediastinal biopsy for hematologic malignancies

F Venuta, EA Rendina, EO Pescarmona, T de Giacomo, I Flaishman, E Guarino and C Ricci
Department of Thoracic Surgery, University of Rome La Sapienza, Italy.

OBJECTIVE: We retrospectively evaluated our experience with outpatient surgical biopsy of mediastinal lesions in patients with hematologic malignancies, its cost-effectiveness and ability to allow diagnosis. METHODS: Eighty patients underwent outpatient surgical biopsy of mediastinal lesions related to hematologic malignancies (50 cervical mediastinoscopies, 24 anterior mediastinotomies and six video-assisted thoracoscopies). Eight patients had a superior vena cava syndrome, five had lesions residuing or relapsing after chemo-radiotherapy and six and had been treated with steroids before diagnosis; in five cases the biopsy had been previously performed at other hospitals without achieving a positive diagnosis. RESULTS: Ambulatory mediastinal biopsy allowed diagnosis in all cases. Fifty-one patients had Hodgkin disease, 28 had non-Hodgkin lymphoma and one had chronic lymphatic leukemia. There was no operative mortality. Complications were: pneumothorax and bleeding during mediastinoscopy and wound infection after anterior mediastinotomy. CONCLUSIONS: Mediastinal biopsy can be safely performed on an outpatient basis in selected patients with mediastinal involvement due to hematologic malignancies. Costs were markedly reduced with respect to in-hospital procedures.

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