Non-grasping en bloc mediastinal lymph nodes dissection in uniportal video-assisted thoracic surgery for lung cancer
10.3760/cma.j.issn.1001-4497.2015.011.002
- VernacularTitle:无抓持整块纵隔淋巴结清扫在单孔胸腔镜肺癌手术中的应用
- Author:
Zongwu LIN
;
Junjie XI
;
Wei JIANG
;
Songtao XU
;
Qun WANG
- Publication Type:Journal Article
- Keywords:
Video-assisted thoracic surgery;
Mediastinal lymph nodes dissection;
Lung cancer;
Uniportal
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2015;31(11):645-648
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.
