Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients
A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses ves...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/9/6/770 |
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| author | Roberto Cascone Annalisa Carlucci Gaetana Messina Antonio Noro Mary Bove Giovanni Natale Caterina Sagnelli Giorgia Opromolla Mario Martone Carlo Santoriello Elena Santoriello Pasquale Verolino Massimiliano Creta Giovanni Vicidomini Alfonso Fiorelli Mario Santini Antonello Sica |
| author_facet | Roberto Cascone Annalisa Carlucci Gaetana Messina Antonio Noro Mary Bove Giovanni Natale Caterina Sagnelli Giorgia Opromolla Mario Martone Carlo Santoriello Elena Santoriello Pasquale Verolino Massimiliano Creta Giovanni Vicidomini Alfonso Fiorelli Mario Santini Antonello Sica |
| author_sort | Roberto Cascone |
| collection | DOAJ |
| description | A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy. |
| first_indexed | 2024-03-10T10:13:35Z |
| format | Article |
| id | doaj.art-53d7b041e52b45468dc813afeeda2908 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T10:13:35Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-53d7b041e52b45468dc813afeeda29082023-11-22T00:58:58ZengMDPI AGHealthcare2227-90322021-06-019677010.3390/healthcare9060770Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma PatientsRoberto Cascone0Annalisa Carlucci1Gaetana Messina2Antonio Noro3Mary Bove4Giovanni Natale5Caterina Sagnelli6Giorgia Opromolla7Mario Martone8Carlo Santoriello9Elena Santoriello10Pasquale Verolino11Massimiliano Creta12Giovanni Vicidomini13Alfonso Fiorelli14Mario Santini15Antonello Sica16Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyDepartment of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyPlastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyDepartment of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyA significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy.https://www.mdpi.com/2227-9032/9/6/770mediastinal lymphomamediastinotomyChamberlain procedureultrasonography |
| spellingShingle | Roberto Cascone Annalisa Carlucci Gaetana Messina Antonio Noro Mary Bove Giovanni Natale Caterina Sagnelli Giorgia Opromolla Mario Martone Carlo Santoriello Elena Santoriello Pasquale Verolino Massimiliano Creta Giovanni Vicidomini Alfonso Fiorelli Mario Santini Antonello Sica Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients Healthcare mediastinal lymphoma mediastinotomy Chamberlain procedure ultrasonography |
| title | Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients |
| title_full | Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients |
| title_fullStr | Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients |
| title_full_unstemmed | Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients |
| title_short | Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients |
| title_sort | ultrasound guided anterior mediastinotomy a feasible tool for critical lymphoma patients |
| topic | mediastinal lymphoma mediastinotomy Chamberlain procedure ultrasonography |
| url | https://www.mdpi.com/2227-9032/9/6/770 |
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