The Application Of Video Mediastinoscopy In Mediastinal Tumor And Mediastinal Lymph Nodes In The Diagnosis And Treatment

Objective： Discussion Video mediastinoscopy in mediastinal tumor andmediastinal lymph node enlargement value value diagnosis and treatment of lungcancer before surgery to provide a theoretical basis for bronchial installments.Methods：A retrospective analysis of the clinical data of218cases ofmediastinal mass or mediastinal lymphadenopathy line television mediastinoscopypatients.1、The218cases of patients were divided into A, B groups according to theirdifferent preoperative clinical symptoms, chest CT, PET-CT, electronic bronchoscopyand other results. Group A: patients with mediastinal mass or mediastinal lymphnodes did not confirm the diagnosis of158cases; Group B: Clinical diagnosis ofsuspected lung cancer or non-small cell lung cancer and60patients with mediastinallymphadenopathy.2、Clinical data collected two groups of patients (including age and sex, clinicalmanifestations, smoking index, chest CT or PET-CT, electronic bronchoscopy,preoperative diagnosis, postoperative pathological diagnosis.)3、According to data collected by two groups of surgical patients for statisticalanalysis. A major group were compared in terms of gender, age, clinical symptoms,smoking index, analyze common type of mediastinal disease and clinical features.Group B major by chest CT or PET-CT,and pathological diagnosis after surgery TVor mediastinoscopy contrast, to be analyzed to determine the staging of lung cancer.4、Data analysis using SPSS18.0statistical software.Results：1、158cases of mediastinal mass or mediastinal lymph nodes in patients withpostoperative pathological diagnosis: Benign106cases, including13cases ofgranulomatous disease,34cases of mediastinal lymph node tuberculosis, mesothelialcysts five cases,51cases of sarcoidosis, mediastinal neurofibroma three cases;vicious42cases, including neuroendocrine carcinoma, lymphoma, five cases,adenosquamous carcinoma in7cases,8cases of small cell carcinoma, adenocarcinoma,10cases of squamous cell carcinoma,11cases;10cases oflymphoid tissue, without the express pathology, diagnosis rate of93.67%.2、A group of benign and malignant cases of gender, age, clinical symptomsand smoking index, the statistical comparison, there was a significant difference (P<0.05).3、Chest CT for mediastinal tumor and mediastinal lymph nodes to determinethe sensitivity of malignant and benign was81.6%, specificity was56.3%.4、Group B, the television mediastinoscopy surgery, pathological diagnosisshowed:52cases of malignancy, chronic lymphadenitis eight cases, this eight casesof pulmonary surgical pathology diagnosis of lung cancer, squamous cell carcinomain4cases,3cases of adenocarcinoma, adenosquamous carcinoma cases, includingone case of adenocarcinoma with mediastinal lymph node metastasis, clinicalcompliance rate of87.5%.Conclusions：1、Video mediastinoscopy for mediastinal tumor, diagnosis and treatment ofmediastinal lymph node enlargement has significant practical value, safe, effective,accessible directly pathology samples.2、Video mediastinoscopy clinical staging of lung cancer has an irreplaceablerole.3、Mediastinal mass increases with age and smoking index and mediastinallymph nodes in patients with malignant disease incidence increased in men thanwomen, with hemoptysis, chest tightness, chest pain, hoarseness in patients withmalignant disease incidence increased significantly.