Thoracoscopic Mediastinal Lymph Node Dissection for Lung Cancer

• Published in: Seminars in thoracic and cardiovascular surgery Vol. 24; no. 2; pp. 131 - 141
• Main Authors: Lee, Hyun-Sung, MD, PhD, Jang, Hee-Jin, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2012
• Subjects: Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - surgery; Cardiothoracic Surgery; Humans; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymph Node Excision - adverse effects; Lymph Node Excision - methods; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; mediastinal lymph node dissection; Mediastinum; minimally invasive surgery; Neoplasm Staging; non-small cell lung cancer; robotic surgery; Robotics; Surgery, Computer-Assisted - adverse effects; Thoracic Surgery, Video-Assisted - adverse effects; Treatment Outcome; VATS; non-small cell lung cancer; mediastinal lymph node dissection; VATS; minimally invasive surgery; robotic surgery
• ISSN: 1043-0679; 1532-9488
• DOI: 10.1053/j.semtcvs.2012.02.004

Mediastinal lymph node staging is an important component of the assessment and management of patients with operable non-small cell lung cancer and is necessary to achieve complete resection. During minimally invasive surgery, performance of an equivalent oncologic resection, including adequate lymph node dissection similar in extent to open thoracotomy, is absolutely necessary. We describe our techniques for video-assisted thoracic surgery (VATS) and Robot-assisted VATS (R-VATS) mediastinal lymph node dissection when performing thoracoscopic lobectomy for lung cancer. Between 2008 and 2011, 200 consecutive patients who underwent VATS or R-VATS lobectomies for early stage lung cancer were analyzed. In our series, we removed about 25 lymph nodes per case in both complete VATS and R-VATS. A thorough lymph node dissection in lung cancer is possible with either VATS or R-VATS technique without oncological compromise.