La mediastinoscopia para el diagnóstico de la enfermedad mediastínica: análisis de 181 exploraciones
Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations
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"apellidos" => "Rodríguez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "N." "apellidos" => "Santana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Gámez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "F." "apellidos" => "Rodríguez De Castro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Varela De Ugarte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "J." "apellidos" => "Freixinet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica. Hospital de Gran Canaria Doctor Negrín. Las Palmas de Gran Canaria. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Torácica. Hospital Universitario Clínica Puerta de Hierro. Madrid. España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Cirugía Torácica. Hospital de Gran Canaria Doctor Negrín.Barranco de la Ballena s/n. 35020 Las Palmas de Gran Canaria. España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2001-12-18" "fechaAceptado" => "2002-07-02" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190533" "palabras" => array:5 [ 0 => "Tumores del mediastino" 1 => "Carcinoma broncogé-nico" 2 => "Diagnóstico" 3 => "Mediastinoscopia cervical" 4 => "Mediastinoscopia cervical extendida" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190534" "palabras" => array:5 [ 0 => "Mediastinal tumors" 1 => "Bronchogenic carcinoma" 2 => "Diag-nosis" 3 => "Cervical mediastinoscopy" 4 => "Extended cervical mediastinos-copy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Para validar nuestra experiencia con la utilización de la mediastinoscopia cervical estándar (MCS) y la mediastinos-copia cervical extendida (MCE) en el diagnóstico de las ade-nopatías y masas del mediastino, se ha realizado este estudio entre enero de 1992 y febrero de 2001 sobre 181 pacientes. La MCS y MCE se han indicado para la estadificación gan-glionar por carcinoma broncogénico (grupo I) y en el diagnóstico de las masas mediastínicas (grupo II). En todos los casos se ha efectuado una MCS para explorar la región pa-ratraqueal (2R, 2L, 4R, 4L, 7, 10R, 10L) y en 32, además, una MCE para la ventana aortopulmonar o región subaórtica (área 5) y región paraaórtica (área 6). En el grupo I, la MCS ha demostrado una sensibilidad (S) del 93,6%, especi-ficidad (E) del 100%, un valor predictivo positivo (VPP) del 100%, un valor predictivo negativo (VPN) del 82,8% y una rentabilidad diagnóstica (RD) del 95,1%. La MCE ha tenido una S del 91%, E del 100%, VPP del 100%, VPN del 93,3% y una RD del 96%. Para el grupo II, la MCS ha presentado una S del 93,3%, E 100%, VPP 100%, VPN 81,2% y una RD del 94,8% mientras que la MCE en este grupo ha tenido una S del 80%, E del 100%, VPP 100%, VPN 66,7% y una RD del 85,7%. El porcentaje de complicaciones ha sido del 2,7%, destacando un sangrado por lesión de la vena cava su-perior, una laceración traqueal, una parálisis recurrencial y 2 casos de infección de la herida quirúrgica. La estancia me-dia postoperatoria ha sido de 36 h y la mortalidad nula</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Concluimos que la MCS es una técnica de gran especifici-dad en la valoración de la afección ganglionar mediastínica por carcinoma broncogénico y la prueba de elección ante la imposibilidad o ausencia de diagnóstico en las lesiones localizadas en el mediastino medio. La MCE es una alternativa váli-da y segura a la mediastinotomía anterior en la valoración de las adenopatías y masas que ocupan las regiones paraaórtica y ventana aortopulmonar, presentando una elevada rentabili-dad diagnóstica, una baja morbilidad y una nula mortalidad</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">To validate our experience with standard cervical mediasti-noscopy (SCM) and extended cervical mediastinoscopy (ECM) to diagnose mediastinal nodes and masses, we studied 181 patients between January 1992 and February 2001. SCM and ECM were indicated for diagnostic staging of nodes rela-ted to bronchogenic carcinoma (Group I) or of mediastinal masses (Group II). An SCM was performed in all cases to ex-plore the paratracheal region (2R, 2L, 4R, 4L, 7, 10R and 10L); in 21 additional cases, an ECM was performed to explo-re the aortopulmonary window or the subaortic region (area 5) and the para-aortic region (area 6). In Group I, the sensiti-vity of SCM was 93.6% and specificity was 100%; the positive predictive value (PPV) was 100%, the negative predictive va-lue (NPV) was 82.8%, and the diagnostic yield was 95.1%. The sensitivity of ECM was 91% and specificity was 100%; PPV was 100%, NPV 93.3% and yield was 96%. In Group II, the sensitivity was 93.3%, specificity 100%, PPV 100%, NPV 81.2% and diagnostic yield 94.8%. The sensitivity of ECM in this group was 80%, specificity was 100%, PPV 100%, NPV 66.7% and yield 85.7%. A 2.7% complication rate was obser-ved, with one case of bleeding after injury to the superior vena cava, one tracheal lesion, one recurring paralysis and two ca-ses of surgical wound infection. The mean postoperative stay was 36 hours and mortality was zero</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We conclude that SCM is highly specific for the evaluation of mediastinal node involvement in bronchogenic carci-noma and it is the approach of choice when a diagnosis of lesions located in the mid-mediastinal region has not been reached. ECM is a valid, safe alternative to anterior medias-tinotomy for staging nodes and masses occupying para-aor-tic zones or the aortopulmonary window, with good diag-nostic yield, low morbidity and absence of mortality</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 3 | 6 |
| 2024 October | 55 | 26 | 81 |
| 2024 September | 65 | 31 | 96 |
| 2024 August | 68 | 54 | 122 |
| 2024 July | 41 | 45 | 86 |
| 2024 June | 69 | 49 | 118 |
| 2024 May | 71 | 38 | 109 |
| 2024 April | 30 | 38 | 68 |
| 2024 March | 41 | 40 | 81 |
| 2024 February | 43 | 45 | 88 |
| 2024 January | 0 | 19 | 19 |
| 2023 December | 0 | 10 | 10 |
| 2023 November | 0 | 13 | 13 |
| 2023 October | 2 | 14 | 16 |
| 2023 September | 0 | 11 | 11 |
| 2023 August | 0 | 1 | 1 |
| 2023 July | 0 | 1 | 1 |
| 2023 June | 0 | 1 | 1 |
| 2023 March | 3 | 9 | 12 |
| 2023 February | 31 | 21 | 52 |
| 2023 January | 19 | 27 | 46 |
| 2022 December | 27 | 29 | 56 |
| 2022 November | 38 | 29 | 67 |
| 2022 October | 30 | 37 | 67 |
| 2022 September | 20 | 27 | 47 |
| 2022 August | 29 | 41 | 70 |
| 2022 July | 21 | 31 | 52 |
| 2022 June | 26 | 29 | 55 |
| 2022 May | 20 | 30 | 50 |
| 2022 April | 34 | 41 | 75 |
| 2022 March | 29 | 41 | 70 |
| 2022 February | 25 | 25 | 50 |
| 2022 January | 34 | 28 | 62 |
| 2021 December | 13 | 47 | 60 |
| 2021 November | 27 | 44 | 71 |
| 2021 October | 24 | 33 | 57 |
| 2021 September | 20 | 43 | 63 |
| 2021 August | 30 | 33 | 63 |
| 2021 July | 18 | 26 | 44 |
| 2021 June | 20 | 33 | 53 |
| 2021 May | 18 | 35 | 53 |
| 2021 April | 25 | 42 | 67 |
| 2021 March | 49 | 21 | 70 |
| 2021 February | 63 | 14 | 77 |
| 2021 January | 42 | 15 | 57 |
| 2020 December | 19 | 12 | 31 |
| 2020 November | 24 | 11 | 35 |
| 2020 October | 21 | 9 | 30 |
| 2020 September | 16 | 10 | 26 |
| 2020 August | 21 | 11 | 32 |
| 2020 July | 23 | 27 | 50 |
| 2020 June | 22 | 27 | 49 |
| 2020 May | 33 | 28 | 61 |
| 2020 April | 41 | 28 | 69 |
| 2020 March | 13 | 44 | 57 |
| 2020 February | 78 | 33 | 111 |
| 2020 January | 49 | 32 | 81 |
| 2019 December | 30 | 39 | 69 |
| 2019 November | 22 | 17 | 39 |
| 2019 October | 3 | 17 | 20 |
| 2019 September | 41 | 47 | 88 |
| 2019 August | 21 | 18 | 39 |
| 2019 July | 12 | 51 | 63 |
| 2019 June | 7 | 36 | 43 |
| 2019 May | 21 | 63 | 84 |
| 2019 April | 18 | 40 | 58 |
| 2019 March | 11 | 16 | 27 |
| 2019 February | 7 | 16 | 23 |
| 2019 January | 10 | 18 | 28 |
| 2018 December | 11 | 14 | 25 |
| 2018 November | 36 | 23 | 59 |
| 2018 October | 38 | 11 | 49 |
| 2018 September | 19 | 7 | 26 |
| 2018 August | 1 | 0 | 1 |
| 2018 May | 11 | 1 | 12 |
| 2018 April | 7 | 3 | 10 |
| 2018 March | 6 | 6 | 12 |
| 2018 February | 6 | 7 | 13 |
| 2018 January | 12 | 8 | 20 |
| 2017 December | 7 | 9 | 16 |
| 2017 November | 8 | 17 | 25 |
| 2017 October | 8 | 23 | 31 |
| 2017 September | 6 | 14 | 20 |
| 2017 August | 9 | 14 | 23 |
| 2017 July | 6 | 13 | 19 |
| 2017 June | 13 | 20 | 33 |
| 2017 May | 11 | 19 | 30 |
| 2017 April | 6 | 22 | 28 |
| 2017 March | 5 | 33 | 38 |
| 2017 February | 4 | 8 | 12 |
| 2017 January | 2 | 13 | 15 |
| 2016 December | 11 | 15 | 26 |
| 2016 November | 22 | 20 | 42 |
| 2016 October | 22 | 15 | 37 |
| 2016 September | 23 | 22 | 45 |
| 2016 August | 17 | 6 | 23 |
| 2016 July | 18 | 8 | 26 |
| 2016 June | 25 | 13 | 38 |
| 2016 May | 12 | 6 | 18 |
| 2016 April | 10 | 0 | 10 |
| 2016 March | 6 | 1 | 7 |
| 2016 February | 12 | 2 | 14 |
| 2016 January | 31 | 16 | 47 |
| 2015 December | 22 | 13 | 35 |
| 2015 November | 27 | 10 | 37 |
| 2015 October | 465 | 1 | 466 |
| 2015 September | 475 | 0 | 475 |
| 2015 August | 392 | 0 | 392 |
| 2015 July | 520 | 0 | 520 |
| 2015 June | 417 | 0 | 417 |
| 2015 May | 573 | 0 | 573 |
| 2015 April | 465 | 0 | 465 |
| 2015 March | 524 | 0 | 524 |
| 2015 February | 431 | 0 | 431 |
| 2015 January | 351 | 0 | 351 |
| 2014 December | 316 | 0 | 316 |
| 2014 November | 394 | 0 | 394 |
| 2014 October | 407 | 0 | 407 |
| 2014 September | 303 | 0 | 303 |
| 2014 August | 233 | 0 | 233 |
| 2014 July | 225 | 0 | 225 |
| 2014 June | 256 | 0 | 256 |
| 2014 May | 238 | 0 | 238 |
| 2014 April | 205 | 0 | 205 |
| 2014 March | 236 | 0 | 236 |
| 2014 February | 190 | 0 | 190 |
| 2014 January | 167 | 0 | 167 |
| 2013 December | 144 | 0 | 144 |
| 2013 November | 154 | 0 | 154 |
| 2013 October | 210 | 0 | 210 |
| 2013 September | 154 | 0 | 154 |
| 2013 August | 161 | 0 | 161 |
| 2013 July | 135 | 0 | 135 |
| 2013 June | 138 | 0 | 138 |
| 2013 May | 108 | 0 | 108 |
| 2013 April | 118 | 0 | 118 |
| 2013 March | 21 | 0 | 21 |
| 2000 January | 6431 | 0 | 6431 |
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