Mediastinotomy Definition, Procedure, Complications, Cervical Approach

Mediastinotomy is a surgical procedure in which a small opening is made in mediastinum to take a view of inside of cavity between lungs and chest wall. Through this hole or opening, an endoscope is introduced which shows the inner part of lungs. The introduction of endoscope in mediastinum opening, is termed as mediastinoscopy. These two process are complementary to each other. Mediastinum is the protective layer which separates two cavities. It is present outside the lungs boundary and separates lungs from the chest wall cavity. In case of any pulmonary problem, mediastinotomy is performed to check the inner functioning. This procedure is performed for the purpose of biopsy.

Biopsy is the diagnostic test which is performed to take samples from any site of body. Mediastinotomy is performed in case of mediastinal lymphadenopathy and to evaluate the stage of lung cancer and esophageal cancer. There are many other procedures which are introduced now a days to evaluate the stage of cancer and the need of mediastinotomy has decreased. It is a simple process with almost zero complications. But there are some conditions in which mediastinotomy is contraindicated. These conditions include tracheostomy, median sternostomy, superior vena cava syndrome, aneurysm of aortic arch and last but not least previous mediastinal irradiation.

Mediastinotomy Definition, Procedure, Complications, Cervical Approach

Mediastinotomy Procedure

After administration of general anesthesia, surgeon will make a small incision in the chest and will move aside the muscles to check the inner view. Now with the help of surgical instruments, surgeon will take samples inside of cavity. The space between the lungs and heart is also examined. After taking sample for test, the wound will be sewed again. The stitches and wound will be covered with bandage or dressing. The total time required for the surgery is about 30 min to 2 hours. Patient may feel a little bit of pain during procedure.

Mediastinotomy Complications

There are less than 1 percent complications associated with mediastinotomy. So it is a safe procedure. But the possible complications for mediastinotomy are

Hoarseness, excessive bleeding, anemia due to loss of blood, there may be an infection due to unsterilized instruments and open wound. Lymphatic fluid may leak in to the chest which is termed as chylothorax. The organs of chest cavity may get damaged. Pneumothorax is the common complication in which air got trapped in between the chest wall and lungs. Patient should avoid all those factors which may increase the chances of complications. These factors include smoking, some chronic diseases and drinking.

Mediastinotomy Cervical Approach

Mediastinotomy can also be performed in case of problem in mediastinum in cervix of brain. It is performed to evaluate staging of mediastinal lymphadenopathy nodes specially in patients suffering from bronchogenic carcinoma. It is performed to take mediastinal masses. It is a simple procedure even in case of cervical mediastinotomy. The morbidity and mortality rate of cervical mediastinotomy is also extremely low. The useful aspects of this surgery are greater in number. But now a days other procedures have been introduced to do biopsy of brain. Mediastinotomy of cervical region is a complicated and hard task but the results are good.

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