What is a cervical mediastinoscopy?
Getting a biopsy of glands by through a cut on the neck is called a cervical mediastinoscopy. This is an operation used to get biopsies of the lymph glands in the upper part of the chest (mediastinum), behind the breastbone.
2. Diagnosing the cause of a lump in the chest which was seen on scans.
In both cases the results guide the best course of treatment.
It can take 2 weeks for the laboratory to give results. Results for infections such as TB may take 12 weeks. If we receive results before you are due to come to a clinic appointment we may call you.
You can normally go home on the same day as surgery. This depends on your recovery, so bring an overnight bag just in case.
You will need a responsible adult to be with you for the first 24 hours after surgery. You should not drive for 48 hours and you should not go back to work before 72 hours. Drink plenty of fluids and rest when you go home.
The lower part of your neck and your throat will be sore but taking paracetamol as needed should keep you comfortable.
If you need to have a chest drain or have problems with bleeding you will need to stay in hospital longer.
The risks here are a guide; your own risk may vary. You should discuss the risks and benefits of surgery with your consultant, especially if you are concerned.
- Minor and more common complications
Wound infection. If your wound becomes more sore, red or leaks fluid there may be a wound infection. This is usually treated with antibiotics and dressings.
Bleeding. Bleeding is usually minimal but you should expected some bruising and swelling on the neck.
- Major and more rare complications
Collapsed lung. The top of the lung is close to where biopsies need to be taken. Air may get into the pleural space and cause a collapsed lung. This may settle with observation or require a chest drain to be inserted to remove the air. If you have chest pain or feel short of breath after your procedure tell your nurse.
Hoarse voice. The nerves that supply the voice box run close to the windpipe. They may become stretched or damaged during the operation. This would result in a hoarse voice which is usually temporary but rarely may be permanent.
Injury to large blood vessels that are behind the breastbone. There is a very very small risk of major bleeding ( 1 in 500 cases) if one of these vessels is damaged. If there is severe bleeding you may need a blood transfusion. Bleeding can usually be controlled and the vessel repaired. To do this an additional incision would need to be made called a median sternotomy. This is a vertical incision, approximately 20cm long, in the centre of the chest which goes through the breastbone. It is needed to get into the chest to control severe bleeding.
Death is possible but very rare, it is usually happens if a person has a medical condition that leads to a complication.
Blood clots. This is general risk with any operation that involves staying in hospital.
If you do not want to have an operation to get a diagnosis other options may include:
- Biopsies of the lymph glands can be taken using ultrasound during bronchoscopy (EBUS). This is usually tried first but samples may be too small or difficult to access to get a diagnosis.
- Relying on existing tests (such as CT scans) to judge which disease is most likely
- Repeating a previous test.
It is your choice whether to go ahead with surgery. We will respect your wishes and support you in choosing the treatment that suits you best. You are always welcome to seek a second opinion.