Modified Chamberlain Procedure Is an Alternative Option with or Without VATS Still a Gold Standard Technique: A 10 Years Experience

Abstract

Introduction: Mediastinum is divided in anterior, middle and posterior part. Mediastinum contains heart, lung, thymus, lymph nodes and nerves. A varied spectrum of disease can arise from these organs. It poses a challenge to the clinicians to confirm the diagnosis. A Mediastinal lesion grows beyond the individual division of origin in advanced stages. It is the biopsy and histopathological study that gives us an idea about probable site or organ of origin and nature of the lesion. Diagnostic biopsy approach for such cases would be CT guide FNAC, Mediastinoscopy, Video Assisted Thoracoscopic Surgery, Chamberlain procedure and Thoracotomy. Anterior mediastinotomy known as chamberlain procedure is time tested technique for confirmation of the mediastinal lesions. Objective: To re-evaluate the technique of chamberlain procedure and its modifications to confirm the diagnosis of various lesions found in the mediastinum. Chamberlain procedure and other mediastinoscopic biopsy techniques have been replaced with VATS in most centres. In view of difficulties in gaining VATS instruments as they are expensive and its steep learning curve, we continue to do chamberlain procedure for mediastinal lesions biopsy. Method: We studied 75 patients, presented with various mediastinal mass or lung lesions. Most of these lesions were not identified from another mode of investigations. Chamberlain Procedure adopted to confirm the diagnosis, asses the stage of disease, operability status and to plan the treatment. Conclusion: Chamberlain procedure is still a gold standard over multiple other techniques in diagnosis and confirmation of the mediastinal diseases. It allows accessing any plane and location in the mediastinum. Result: Chamberlain procedure and biopsy can be done for diagnosis and confirmation of all kinds of mediastinal lesions. Compared to VATS, chamberlain procedure results and outcomes are similar.