Kshanovsky O. Rationality and assessment of the effectiveness of diagnostics of mediastinal lymphadenopathy syndrome with the use of invasive methods

The aim of the dissertation is to increase the effectiveness of diagnostics of mediastinal lymphadenopathy syndrome by improving invasive methods and creating an algorithm for their optimal use. The informativeness of non-invasive methods of diagnosis of mediastinal lymphadenopathy syndrome was 21,4 %. The frequency of false diagnoses was determined by using only non-invasive diagnostic methods was 64,3 %. The informativness (sensitivity) of invasive diagnostic methods were determined: video-assisted thoracoscopic biopsy without minothoracotomy - 90,2 %, video-assisted thoracoscopic biopsy with minithoracotomy - 94,4 %, mediastinoscopy - 88,9 %, endobronchial ultrasound transbronchial needle aspiration biopsy - 72,9 %, open biopsy - 100,0 %. The intraoperative and postoperative complications of invasive diagnostic methods have been studied and analyzed. A new method for the prevention of postoperative complications with video-assisted thoracoscopic biopsy of the mediastinal lymph nodes was developed, which reduced the overall rate of postoperative complications from 13,1 % to 2,1 % of cases. An algorithm for the use of invasive methods for diagnosis of mediastinal lymphadenopathy syndrome has been developed.