Combined video-assisted mediastinoscopy and video-assisted thoracoscopy in the management of XXXX .

@entity1 @entity5 @entity2 @entity189 @entity3
BACKGROUND: This study seeks to assess the safety and usefulness of combined video-assisted mediastinoscopy and video-assisted thoracoscopy in the management of @entity1 with @entity2 . METHODS: Ten consecutive @entity1 with @entity2 were evaluated. Indications for this combined approach included inconclusive findings from imaging techniques concerning locoregional extension and resectability; possible involvement of different structures not accessible to a single procedure; and failure to obtain histologic diagnosis by a single technique. RESULTS; Histologic diagnosis was obtained in 6 @entity1 without preoperative histologic typing. In 3 @entity1 , in contrast with preoperative imaging studies, combined thoracoscopy and mediastinoscopy showed the resectability of the @entity5 and the absence of metastatic mediastinal lymph nodes. These findings were confirmed at thoracotomy. In 3 other @entity1 prevascular lymph nodes @entity3 were found. They underwent neoadjuvant chemotherapy; at subsequent operation, a complete resection was possible. In the remaining four cases combined exploration proved definitive contraindications for operation (recognition of oat-cell @entity189 , n = 2; T4 status, n = 1; T3N2, n = 1). CONCLUSIONS: Combined video-assisted mediastinoscopy and video-assisted thoracoscopy seems to be a safe and useful tool in the management of selected @entity1 with @entity2 . Both the extent of @entity5 and the possible intrathoracic spread may be exhaustively evaluated. In @entity1 with @entity2 a complete exploration of the aortopulmonary window is possible.
