History of extended cervical mediastinoscopy.

We appreciate and read with great interest the article by Call et al. [1] about their extensive experience with extended mediastinoscopy. We fully support their conclusion. In our personal experiencewith now 108 cases extendedmediastinoscopyrevealedN2disease instations5or6 in17%ofallpatients. In 11%ofall patients only these stationswerepositive,meaning that with standard medastinoscopy without extended mediastinoscopy N2 disease would have been missed. However, we would like to comment on one more thing: Ginsberg is usually quoted as the inventor of extended mediastinoscopy referring to his publication in 1987 [2]. However it seems adequate and will certainly not reduce Ginsberg’s innumerable achievements in the field of thoracic surgery to honour that Specht in 1965 [3] already described the technique of extended or ‘expanded’ mediastinoscopy (‘Erweiterte Mediastinoskopie’ was the original title) what is rarely noticed and almost never cited. Moreover, ‘Erweiterte Mediastinoskopie’ for Specht not only included the technique rediscovered and populized later by Ginsberg for the paraaortal regionbutalsotheexplorationofthelowerandposterior mediastinum and the hilar and interlobar lymph nodes. Specht’s publications and illustrations are very interesting.