Lymph node sampling of suspicious nodes via incision 3-4 cm above the sternal notch, dissecting through the pre-tracheal fascia corresponds to which procedure?

Lymph node sampling of suspicious nodes via incision 3-4 cm above the sternal notch, dissecting through the pre-tracheal fascia corresponds to which procedure?

• A. Mediastinoscopy
• B. Chamberlain procedure
• C. Pleural biopsy
• D. VATS

Answer: (A)

The described approach is a transcervical mediastinoscopic biopsy. An incision 3–4 cm above the sternal notch with dissection through the pretracheal fascia is the classic entry to the superior mediastinum, allowing sampling of paratracheal and other mediastinal lymph nodes. This route is specifically used for staging lung cancer and diagnosing mediastinal diseases. Chamberlain procedure, by contrast, is an anterior mediastinotomy through a left parasternal approach to access different mediastinal spaces, not via the pretracheal plane. Pleural biopsy and VATS involve the pleural space or thoracic cavity access through intercostal ports, not the mediastinal transtracheal route described here. Thus, the described sampling method corresponds to mediastinoscopy.

The described approach is a transcervical mediastinoscopic biopsy. An incision 3–4 cm above the sternal notch with dissection through the pretracheal fascia is the classic entry to the superior mediastinum, allowing sampling of paratracheal and other mediastinal lymph nodes. This route is specifically used for staging lung cancer and diagnosing mediastinal diseases.

Chamberlain procedure, by contrast, is an anterior mediastinotomy through a left parasternal approach to access different mediastinal spaces, not via the pretracheal plane. Pleural biopsy and VATS involve the pleural space or thoracic cavity access through intercostal ports, not the mediastinal transtracheal route described here.

Thus, the described sampling method corresponds to mediastinoscopy.