The Safety and Usefulness of Combined Video-Assisted Mediastinoscopic Lymph Adenectomy and Video-Assisted Thoracic Surgery Lobectomy for Left-sided Lung Cancer.
- Author:
Hee Suk JUNG
1
;
Yong Hee KIM
;
Seung Il PARK
;
Dong Kwan KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. kimyh67@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Lung neoplasms;
Mediastinoscopy;
Mediastinal lymph nodes;
Staging;
Video-assisted Thoracoscopy
- MeSH:
Chest Tubes;
Humans;
Lung;
Lung Neoplasms;
Lymph Node Excision;
Lymph Nodes;
Mediastinoscopes;
Mediastinoscopy;
Pneumonia;
Postoperative Complications;
Retrospective Studies;
Thoracic Surgery, Video-Assisted;
Vocal Cord Paralysis
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2010;43(1):33-38
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. MATERIAL AND METHOD: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. RESULT: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (> or =10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. CONCLUSION: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.
