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Hilar lymphadenectomy, regions 10 & 11

Background

Video-assisted toracoscopic pulmonary lobectomy (VL) has gained wide acceptance in the thoracic surgical community. The accuracy of mediastinal staging, its clinical value, and VL as a therapeutic tool for complete mediastinal lymph node dissection in the treatment of lung cancer is not well elucidated. Our clinical question tackles the question hilar lymphadenectomy.

Key words: VATS, lobectomy, lymphadenectomy

Materials/methods

Histopathological results for 50 VL patients with pT1-2N0M0 were compared with same results for 50 patients after open lobectomy (OL) in terms of numbers of lymph nodes dissected in the regions 10 and 11. Patients with apparent lymphadenopathies on preoperative CT scan were excluded from the analysis.

Results

Our retrospective analysis recorded no statistically significant differences between the two groups (VL and OL) in terms of the numbers of dissected lymph nodes for the regions 10 and 11. We recorded more intraoperative problems in the VL group regarding the extraction of interlobar lymph nodes compared to OL patients.

Conclusion

Video-assisted toracoscopic pulmonary lymphadenectomy is technically challenging but feasible. Recent long term survival studies confirmed oncological efficiency of the VL. Future studies end expert consensus should focus on determining the guidelines for adequate approach towards it’s extend.

A.Hojski, MD, PhD; UMC Maribor, Slovenia

Corresponding author: Aljaž Hojski, MD, PhD, thoracic surgeon
e-mail: aljaz.hojski@gmail.com
(mobile) +386 41393659

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