A retrospective analysis of high-risk patients for mediastinoscopy

Background: This study aims to investigate possible factors influencing mortality and morbidity rates in high-risk patients for mediastinoscopy. Methods: Between January 2006 and January 2011, 216 patients (54 females, 162 males; mean age 60.8 +/- 9.9 years; range 30 to 85 years) who underwent mediastinoscopy under general anesthesia in Istanbul University, Cerrahpasa Faculty of Medicine, Department of Thoracic Surgery were included. Date of surgery, duration of surgery, amount of intraoperative bleeding, amount of blood transfusion, postoperative hemoglobin level, type of surgery, diagnostic or staging technique, thoracotomy following mediastinoscopy, postoperative complications, the length of hospital stay, hospitalization in the intensive care unit and mortality in the intensive care unit and clinic were recorded by examining the medical records and medical files of the patients, anesthesiology follow-up forms and nurse observation charts. Results: The most common postoperative complications were sepsis, respiratory and cardiovascular system problems. Comorbidities including diabetes mellitus and cardiovascular diseases and smoking in patients aged >= 50 years were particularly associated with higher mortality and morbidity rates. Conclusion: We suggest that mediastinoscopy with an experienced surgical team, smoking cessation four to six weeks before surgery and a thorough identification of risk factors before surgery may decrease the mortality and morbidity rates.