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A mediastinoscopy is a test to examine the space in the chest between the lungs (mediastinum) using an endoscopeendoscopeA thin, tube-like instrument with a light and lens used to examine or treat organs or structures in the body. (a thin, tube-like instrument with a light and lens).

Why a mediastinoscopy is done

A mediastinoscopy is done to:

  • identify certain infections or inflammation
  • diagnose lung diseases or tumours
  • see if cancer has spread to lymph nodes in the mediastinum
  • biopsy mediastinal lymph nodes or abnormal growths in the mediastinum
  • help stage lung cancer and determine if lung tumours are operable or not

How a mediastinoscopy is done
  • Preparation for a mediastinoscopy can vary but usually includes:
    • Do not eat or drink anything for at least 8 hours before the test.
  • A mediastinoscopy is done in a hospital operating room. Some people may be able to go home the same day as the procedure once they can swallow, but need to arrange for a ride home.
  • A mediastinoscopy is done while the person is under general anesthetic.
  • A mediastinoscope is put through a small cut (incision) at the base of the neck, just above the breastbone. The mediastinoscope is inserted into the middle part of the chest along the windpipe (trachea).
  • Samples of cells or tissue are taken from the lymph nodes or from other suspicious areas in the mediastinum.
  • The mediastinoscope is then removed and the incision is closed with stitches and covered with a bandage.
  • There will be some discomfort or tenderness at the incision site and neck after the procedure.

Potential side effects

The risks from mediastinoscopy are:

  • sore throat or trouble swallowing
  • bleeding
  • hoarseness – can be caused by injury to a nerve near the voice box (larynx)
  • swelling of the neck
  • infection
  • breathing difficulties
  • low blood oxygen level
  • buildup of air in the space between the lungs and the wall of the chest that causes the lung to partially or completely collapse (pneumothorax)
  • blockage of a blood vessel due by an air bubble (air embolism)
  • air from the chest cavity gets into the tissues under the skin of the chest, neck or face (subcutaneous emphysema)
  • chest pain
  • tear (puncture) in the trachea or esophagus
  • damage to a blood vessel
  • changes in blood pressure or heart rate

What the results mean

A mediastinoscopy can show:

  • enlarged or abnormal lymph nodes
  • lung diseases, such as sarcoidosis and tuberculosis
  • cancer, such as lung cancer, pleural mesothelioma and lymphoma

What happens if a change or abnormality is found

The doctor will decide whether further tests, procedures, follow-up care or additional treatment is needed.


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