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J Thorac Cardiovasc Surg 2006;131:750-751
© 2006 The American Association for Thoracic Surgery

Brief Communication

Ultrasonography-assisted videomediastinoscopy in superior vena cava obstruction

Eugenio Pompeo, MD * , Federico Tacconi, MD, Mario Marino, MD, Antonio Gatti, MD, Tommaso Claudio Mineo, MD

Division of Thoracic Surgery, Policlinico Tor Vergata University, Rome, Italy.

Received for publication August 30, 2005; accepted for publication September 9, 2005.

* Address for reprints: Eugenio Pompeo, MD, Cattedra di Chirurgia Toracica, Policlinico Università Tor Vergata, V.le Oxford 81, 00133, Rome, Italy (Email: pompeo@med.uniroma2.it).

The first 20% of the full text of this article appears below.


Figure 1
M. Marino, Sabato, C. Mineo, A. Gatti, E. Pompeo, F. Tacconi (left to right)


Mediastinoscopy has been advocated as the most reliable technique to obtain rapid histologic diagnosis in superior vena cava obstruction. 1,2 Go Nonetheless, iatrogenic injuries eventually requiring salvage sternotomy are reported with a low but constant frequency. 2 Go To reduce the risks of major complications and increase diagnostic yield, we have integrated videomediastinoscopy with ultrasonographic assistance in patients with superior vena cava obstruction.

Patients and Methods

Between January 2002 and March 2005, we performed ultrasonography-assisted videomediastinoscopy (UAM) in 12 patients with superior vena cava obstruction. The major sign of presentation was neck swelling in all patients. Other symptoms and signs included dyspnea in 8 patients, weight loss in 4 patients, and hemoptysis in 1 patient.

UAM was always performed with the patient placed in a supine decubitus position and with the head and truncus elevated. The operative field was widely prepared as for a median sternotomy. General anesthesia with single-lumen armed endotracheal intubation was preferred.

Videomediastinoscopy (Richard Wolf, Knittlingen, Germany) was performed . . . [Full Text of this Article]






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