Thoracoscopic drainage with wound edge protector for descending necrotizing mediastinitis.

It has recently been found that wide recognition of descending necrotizing mediastinitis (DNM) and its resultant early diagnosis can reduce the high mortality rate associated with this disease by allowing for rapid surgical intervention. Nevertheless, thoracotomy remains controversial as a treatment for DNM. We report a successful case of DNM in which the mediastinitis had spread below the carina and which was treated by drainage through cervicotomy and by thoracoscopic drainage with mini-thoracotomy using the newly available wound edge protector called a Lap-protector.