Objective  To investigate the clinical value of video-assisted mediastinoscopy for the diagnosis of a simple mediastinal lymphadenopathy.

  Methods  Clinical data from 138 patients with simple mediastinal lymphadenopathy who underwent video-assisted mediastinoscopy between May 2004 and April 2010 were retrospectively analyzed. Among the patients, 90 were male and 48 were female. The age of the patients ranged from 31 to 72 years old, with an average of 51.3. Clinical examination included cervical mediastinoscopy in 124 cases and parasternal mediastinoscopy in 14.

  Results  Satisfactory amounts of tissue for detailed examination were obtained from all 138 cases that underwent mediastinoscopy. The achievement ratio for the biopsy was i00 %. Conclusive pathologic diagnosis was achieved in 126 of the cases, and the diagnostic accordance rate was 91.3 %. Among the 126 patients, 64 had malignant tumors, including 20 cases of lymphoma and 44 cases of lymph node metastasis from unknown primary sites. Among the total number of patients, 74 were diagnosed with benign diseases, including 34 cases of sarcoidosis, 14 cases of mediastinal lymph node tuberculosis, 10 cases of chronic inflammation, 4 cases of lymph node hyperplasia, and 12 cases of granuloma. The preoperative diagnostic accordance rate reached 27.5 %. A total of 6 cases of postoperative complications occurred.

  Conclusion  Video-assisted mediastinoscopy is safe and useful for the diagnosis of simple mediasfinal lymphadenopathy and is the only way to histopathologically diagnose some specific diseases.