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Original Research: 75 Seminal Studies, 1935–2009 |

Introduction: Surgery

Loren J. Harris, MD, FCCP
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


Copyright © 2009 American College of Chest Physicians


Chest. 2009;136(5_suppl):e26-e27. doi:10.1378/chest.09-2260
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In the first of two surgical articles, Reynders1 chronicles the development of mediastinoscopy and its use in the staging of lung cancer in patients with the disease. This report of the experience of the Surgical Department of the Wilhelmina Gasthuis in Amsterdam looks at mediastinoscopy performed on 122 patients with lung cancer who were scheduled to undergo surgical exploration between 1960 and 1964. Of these, 45 (36.9%) were found to have carcinoma within the mediastinal lymph nodes and 77 (63.1%) were devoid of tumor in these nodes. All 77 patients with negative findings went on to thoracic exploration, of which, 70 (91%) had curative resections. The author compared this with the experience prior to routine mediastinoscopy and found that the complete resection rate rose from 60% to 91%. In addition, he found that, with the routine use of mediastinoscopy, the pneumonectomy rate dropped from 84% to 60%, with a corresponding rise in lobectomy rate from 16% to 40%.

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