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TANISAL MEDIASTINOSKOPILER

Dîagnostic mediastinoscopies

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Abstract (2. Language): 
Mediastinoscopy is an invasive diagnostic method for the examination of the mediastinum with minimal surgical trauma when the diagnosis could not made by non-invasive procedures. Betwecn December 1993 and January 1998 at Yedikule Chest Surgery Centre ist and 2nd Sur-gery Clinics 72 patients with mediastinal vvidening undcrwcnt diagnostic cervical (or anterior) mediastinoscopy. Retrospective elinic study. Of the case 37 werc female, 35 male andranged in age 11-70 (mean 42.8). Biopsies were ta-ken from lymphadenomegalics in 68 cases and dİrectly from the lesion in 4. Pathologic exami-nation revealed tuberculosis in 25 cases, myperplasia İn 5 and İn 5 cases other pathologies we-re reported of 15 cases hat could not be reached a diagnosis 4 underwent thoracotomy, 1 anterior mediastinotomy and 1 patİent required thoractomy due to hemorrhage from azygos vein (morbidity 1.4%). There was no mortality, Statistical analysis showed that diagnostic mediastinoscopy had 92% sensitivity, 100% spesificity, 93% accuracy and 100% posİtive predietive index. Diagnostic mediastinoscopy wîlh its acceptable morbidity and mortality rates should be consi-dered in patients who could not be diagnosed by noninvasive methods.
Abstract (Original Language): 
Mediaslinoskopi (MK), noninvaziv yöntemlerle tanı konulamayan olgularda minimal cerrai travma ile mediastenin incelendiği invaziv bir tanı yöntemidir. Yedikule Göğüs Cerrahisi Merkezi 1. ve 2. Cerrahi Kliniklerinde Aralık 1993 - Ocak 1998 tarihleri arasında tanısı konulamamış, mediastende genişleme mevcut olan 72 olguya tanısal amaçlı servikal (veya anterior) MK yapıldı. Retrospektif klinik araştırma. 37'si kadın, 35'i erkek olan olguların yaşlan 11-70 (ortalama 42.8) arasında değişmekteydi. 68 olguda lenfadenomegalilerden, 4 olguda da kitleden direkt örnekleme yapıldı, Patolojik değerlendirmede 23 olguda sarkoidoz, 25 olguda tüberküloz, 2 olguda Hodgkin lenfoma, 2 olguda küçük hücreli indifferansiye karsitıom, 15 olguda rcaktif hiperplazi ve 5 olguda diğer patolojiler tanımlandı. Tanıya ulaşılamayan 15 olgudan 4'üne torakotomi, birine anterior mediastino-tomi yapıldı. Bir olguda vena azygostan hemoraji nedeniyle toraktomi gerekti (morbidite %1.4). Mortalite gelişmedi. İstatistiki olarak değerlendirmede tanısal MK'nm sensitivitesi %72, spesİfitesi %100, doğruluğu %93 ve pozitif prediktif indeksi % 100 olarak bulundu. Mediastinal patolojilerde, kabul edilebilir morbidite ve mortalite oranları olan tanısal MK girişiminin gözönünde bulundurulması gereklidir.
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