Purpose. We compared the effi cacy and complications of video-assisted mediastinoscopy (VAM) and videoassisted mediastinal lymphadenectomy (VAMLA) for mediastinal staging of lung cancer. Methods. Between March 2006 and July 2008, a total of 157 patients with non-small-cell lung cancer (NSCLC) underwent VAM (n = 113, 72%) or VAMLA (n = 44, 28%). We studied them retrospectively. Data for the operating time, node stations sampled/dissected, number of biopsies, and the patients who were pN0 by mediastinoscopy and underwent thoracotomy were collected. The false-negative rate was calculated. Demographics and operative complications were analyzed.Results. The overall complication rate was 5.7% (n = 9). The most common complication was hoarseness (n = 8).Complications were seen signifi cantly more often after VAMLA than after VAM (11.3% vs. 2.6%, P = 0.04). There were no deaths. The mean number of removed lymph nodes (8.43 ± 1.08) and the station numbers (4.81 ± 0.44) per patient were higher with VAMLA than with VAM (7.65 ± 1.68, P = 0.008 and 4.38 ± 0.80, P = 0.001, respectively). The mean operating time was 44.8 ± 6.6 min for VAM and 82.0 ± 7.8 min for VAMLA. Patients diagnosed as pN2 numbered 9 in the VAMLA group and 27 in the VAM group. The patients diagnosed as pN0 with mediastinoscopy then underwent thoracotomy (VAM 77, VAMLA 32). When they were investigated for the presence of mediastinal lymph nodes, there were three (3.8%) false-negative results in the VAM group and fi ve (15.6%) in the VAMLA group. Sensitivity, accuracy, and negative predictive values for VAM and VAMLA were 0.90/0.97/0.96 and 0.64/0.87/0.84, respectively. Conclusion. VAMLA was found to be superior to VAM with regard to the number of stations and lymph nodes. Complications after VAMLA were common. The sensitivity and NPV of VAM for mediastinal staging are signifi cantly higher than those of VAMLA.

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ECM, which is an effective technique used in the determination of APW lymph node metastasis, was enough to rule out nodal disease with negative predictive value. PET/CT does not reduce the need for invasive procedures in detecting APW lymph node metastasis.

Objective Pulmonary sequestration is rare lung anomaly which had very major theories of origin. The aim of this study was to treat this rare congenital anomaly, pulmonary sequestration, which was not diagnosed of preoperatively, in our centre. Methods A retrospective analysis of 10 cases of pulmonary sequestration operated at the centre between 2000 and 2010. A review of the extralobar and intralobar types of sequestration is discussed. All patients were not diagnosed preoperatively. Results Pulmonary sequestration is found more commonly in women (6 patients). In all patients, the diagnosis was made by exploratory thoracotomy. Six patients had intralobar (one was apical) and 4 were extralobar (one apical). Lobectomy for intralobar and sequestrectomy for extralobar sequestration were performed.Conclusions Although rare, some radiological features are sufficiently suggestive of diagnosis of pulmonary sequestration. We believe that pulmonary sequestration should be considered when intrathoracic masses cannot be differentiated through invasive and non-invasive evaluation. In difficult cases methods such as aortagraphy, doppler angiography and Magnetic Resonance (MR) angiography may be used.

Objectives Theoretically, video-assisted mediastinoscopy (VM) should provide a decrease in the incidence of hoarseness in comparison with conventional mediastinoscopy (CM). Methods An investigation of 448 patients with the NSCLC who underwent mediastinoscopy (n = 261 VM, n = 187 CM) between 2006 and 2010. Results With VM, the mean number of sampled LNs and of stations per case were both significantly higher (n = 7.91 ± 1.97 and n = 4.29 ± 0.81) than they were for CM (n = 6.65 ± 1.79 and n = 4.14 ± 0.84) (p < 0.001 and p = 0.06). Hoarseness was reported in 24 patients (5.4%) with VM procedures resulting in a higher incidence of hoarseness than did CM procedures (6.9% and 3.2%) (p = 0.08). The incidence of hoarseness was observed to be more frequent in patients with left-lung carcinoma who had undergone a mediastinoscopy (p = 0.03). Hoarseness developed in 6% of the patients sampled at station 4L, whereas this ratio was 0% in patients who were not sampled at 4L (p = 0.07). A multivariate analysis showed that the presence of a tumor in the left lung is the only independent risk factor indicating hoarseness (p = 0.09). The sensitivity, NPV, and accuracy of VM were calculated as to be 0.87, 0.95, and 0.96, respectively. The same staging values for CM were 0.83, 0.94, and 0.95, respectively. Conclusion VM, the presence of a tumor in the left-lung, and 4L sampling via mediastinoscopy are risk factors for subsequent hoarseness. Probably due to a wider area of dissection, VM can lead to more frequent hoarseness.