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João Santos Silva contributed in elaboration of the idea and study design, data base creation, manuscript writing and revision. Ana Rita Costa contributed to the database creation and gathering data. Paulo Calvinho contributed in elaboration of the idea, manuscript revision and supervision. First described in 1959 by Carlens, mediastinoscopy has been the gold standard in lung cancer staging and evaluation of mediastinal lymphadenopathies. Recently endobronchial (EBUS-FNA) and endoscopic (EUSFNA) ultrasound guided biopsy with fine needle aspiration have been gaining popularity as an alternative. The need to assess the quality of our department’s performance motivated this paper; this is a report on our ten-year experience and aims to demonstrate the safety and diagnostic accuracy of mediastinoscopy and compare with the literature. A retrospective study was performed after including all patients who underwent mediastinoscopy in our institution from January 2006 to November 2017 -430 cases. 41 patients were excluded due to lack of records. Videomediastinoscopy was introduced at our institution in early 2008. Before that period we report 41 mediastinoscopies performed by classic methods. Patient characteristics are reported in Table 1 and yearly distribution in Fig. 1. Indications were staging of lung cancer and evaluation of mediastinal lymphadenopathies or mass. Lymph nodes tissue was obtained from all patients except two cases of inaccessible mediastinum due to fibrosis. Staging mediastinoscopy was performed accessing routinely stations 4R, 7 and 4L, with two or more stations biopsied in 93.9% of cases. Diagnostic mediastinoscopy was performed as indicated by the suspected pathology. Average hospital stay was 1.3 (±1.9) days, with 88% discharged on day 1 postoperative. No outpatient-based procedures are performed at our institution. Complications occurred in 7 patients (1.8%) and 3 died (0.8%), as Table 2 describes.

Cervical mediastinoscopy: Safety profile, feasibility and diagnostic accuracy in a decade in a single center