HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert J. Downey Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Downey, R. J. Search for Related Content PubMed Articles by Downey, R. J. Related Collections Mediastinum

Ann Thorac Surg 2003;76:876-877
© 2003 The Society of Thoracic Surgeons

Invited commentary

^a Thoracic Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA

e-mail: downeyr@mskcc.org

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

Although the authors would disagree [1], I think that there is only one absolute contraindication to mediastinoscopy: the presence of a tracheostomy which, in my opinion, carries an unacceptably high risk of mediastinoscopy wound infection and mediastinitis. There are four relative contraindications to mediastinoscopy, three of which (prior mediastinal irradiation, prior mediastinoscopy, and superior vena caval syndrome) are associated with an increased risk of bleeding during dissection. The fourth relative contraindication is a prior sternotomy, which is distinct from the other three in that because the pretracheal plane has not been entered, there is no increased risk of bleeding nor of injury to vascular grafts, but, should bleeding occur, the presence . . . [Full Text of this Article]