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J Minim Access Surg. 2018 Sep 3. doi: 10.4103/jmas.JMAS_173_18. [Epub ahead of print]

Video-assisted mediastinoscopy is safe in patients taking antiplatelet or anticoagulant therapy.

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Department of Thoracic Surgery, Pasteur Hospital, Nice, France.



The aim of this study was to report our experience with video-assisted mediastinoscopy (VAM) in patients taking antiplatelet (AP) or anticoagulant therapies focusing on perioperative complications (especially haemorrhagic).

Patients and Methods:

We have done a retrospective study from a prospectively maintained database with diagnostic VAM (01/2008-06/2012). We included 54 patients with AP (41 patients - Group A) and anticoagulant (13 patients - Group B) therapies. The control group was formed by 263 patients (Group C). Data regarding the clinical records of the patients, operative time, per- and post-operative complications, total numbers of biopsies and the results of the pathologic examination were collected. We compared the groups A+B versus C, and then A versus C. Statistical differences were calculated by Chi-square test.


In Group A, we had two minor complications: cardiac arrhythmia and peroperative minor haemorrhage. The mean operative time was 29 min and the mean post-operative stay was 1.08 days. In Group B, we had one minor complication: Peroperative minor haemorrhage. The mean operative time was 35 min and the mean post-operative stay was 1.07 days. In Group C, the mean operative time was 28 min. One death occurred (mortality rate of 0.38%) because of cardiac arrest at the induction of anaesthesia. One major complication occurred (severe respiratory insufficiency needing re-intubation) and eight minor complications. Morbidity rate was 2.28%. Mean post-operative stay was 1.14 days. No statistical difference was noted between groups.


VAM can be safely performed in patients receiving AP or anticoagulant treatments. There is no increase in peroperative bleeding or post-operative compressive cervico-mediastinal haematoma.


Lung neoplasm; minimally invasive; surgery

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