Importance of systemic mediastinal lymphadenectomy in exact staging of bronchogenic carcinoma

Hytych, Vladislav; Tašková, Alice; Horažďovský, Pavel; Konopa, Z; Demes, R; Čermák, Jan; Vrabcova, A; Hoferka, P; Pohnán, Radek

doi:10.4149/bll_2013_121

Cited by 6 publications

(6 citation statements)

References 1 publication

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“…Iatrogenous hemothorax is a distinctive trauma which can occur as a complication of subclavian and jugular cannulation, pleural puncture and lung biopsies or as a complication of cardiothoracic surgery. There were published several reports describing this complication after permanent pacemaker implantation, laparoscopic surgery, transjugular liver biopsy, coronary angiography, translumbar aortography, radiofrequency ablation for lung and liver tumors or oesophageal varices sclerotherapy (6)(7)(8)(9).…”

Section: Since 1925mentioning

confidence: 99%

Treatment of Hemothorax in the Era Of the minimaly Invasive Surgery

Pohnán¹,

Blažková²,

Hytych³

et al. 2019

MMSL

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Hemothorax is a frequent clinical situation often associated with chest injury or with iatrogenic lesions. Spontaneous hemothorax is uncommon and among its cause may include coagulation disorders, pleural, pulmonary or vascular pathology. Diagnostics is based on radiography or ultrasound and thoracentesis which may be also therapeutic solution. The majority of hemothoraxes can be managed non-operatively but hemodynamic instability, the volume of evacuated blood and persisting blood loss or persisting hemothorax require surgery. A surgical approach may vary from open thoracotomy to rapidly developing minimally invasive methods-video-assisted thoracoscopic surgery (VATS) and videothoracoscopy (VTS).

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Section: Since 1925mentioning

confidence: 99%

Treatment of Hemothorax in the Era Of the minimaly Invasive Surgery

Pohnán¹,

Blažková²,

Hytych³

et al. 2019

MMSL

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“…The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection metastasis was an important prognostic factor in patients with NSCLC; therefore, anatomical lobectomy combined with systematic lymph node dissection was thought to be the standard operative method for lung cancer radical resection (5)(6)(7), not only to avoid residual cancer and reduce tumor recurrence but also to ensure postoperative pathological TNM stage and to guide postoperative adjuvant therapy, which has important significance for improving patient survival (7)(8)(9). However, in clinical practice, we found that there remained some deficiencies in routine systemic lymph node dissection, including large wounds created by lymph node dissection, much oozing of blood from the wound, poor protection of vagus nerve and its pulmonary branches, and a large volume of postoperative thoracic drainage.…”

Section: Original Articlementioning

confidence: 99%

The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection

Chen

Huang

et al. 2019

J. Thorac. Dis.

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Background: To evaluate the safety, thoroughness and feasibility of "tunnel-type en bloc mediastinal lymph node dissection" in video-assisted thoracic surgery (VATS) for right non-small cell lung cancer (NSCLC) radical resection, which functionally dissected the lymph nodes of station 2R/4R/7. Methods: A retrospective study was performed in the clinical data of 196 patients with VATS right NSCLC radical resection. According to the different methods of lymph node dissection of station 2R, 4R and 7, they were divided into the tunnel-type group (n=102) and the routine group (n=94). The clinical data of two group were compared. Results: The analyses of the baselines of the two groups are comparable. For lymph nodes dissection of station 2R/4R/7, operation time, the total number, positive number and metastasis incidence shown no significant difference between two groups (P>0.05). However, the amount of bleeding, postoperative thoracic drainage volume, extubation time, hospitalization days, the incidence of postoperative pulmonary infection and chronic cough were significantly lower in the tunnel-type group (P<0.05). There was no significant difference in 3-year recurrence and metastasis and in 3-year survival between tunnel-type group and routine group. Conclusions: The tunnel-type group has more advantages, such as less surgical trauma, shorter hospitalization time, faster postoperative rehabilitation, even less postoperative chronic cough compared with the routine group. Therefore, we believe that the tunnel-type en bloc mediastinal lymph node dissection is a safe, thorough and feasible surgical method, which is worthy of being popularized and applied in the VATS right NSCLC radical resection.

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“…The aim of the diagnostics is to determine the histological classifi cation of tumor (typing), malignity degree (grading), the extent of the malignant process (staging) and the performance status with comorbidities (6).…”

Section: Discussionmentioning

confidence: 99%

Importance of histological verification of mediastinal lymphadenopathy in exact staging of non-small cell bronchogenic carcinoma

Hytych¹,

Pohnán²,

Tašková³

et al. 2014

BLL

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Abstract:Background: Diagnostics and treatment of bronchogenic non-small cell lung carcinoma is a severe clinical problem. Radical surgery is the major treatment modality with the highest chance for a long-time survival. The aim of the study was to map metastasizing of bronchogenic non-small cell lung carcinoma into homolateral mediastinal lymph nodes and to assess the importance of histological verifi cation of mediastinal lymphadenectomy for exact staging and treatment. Results: 50% of the right upper lobe tumors metastasized into group 1 nodes (N1-N4) and 50% into group 3 (N7). 66% of the right lower lobe tumors metastasized into group 3 nodes (N7) and 33.3% into group 1 (N1-4). 20.0% of the left upper lobe tumors metastasized into group 1 nodes (N1-4), 33.0% into group 2 (N5-6), 25.0% into group 3 (N7) and 16.7% into group 4 (N8-9). 23.5% of the left lower lobe tumors metastasized into group 1 nodes (N1-4), 23.5% into group 2 (N5-6), 23.5 % into group 4 (N8-9) and 29.5% into group 3 (N7). 27.6% of examined patients had false positivity of lymph node metastasis according to CT. Conclusion: Histological verifi cation of suspect mediastinal lymph nodes via Endobronchial Ultrasound Biopsy (EBUS) or mediastinoscopy or thoracoscopy is crucial for determining the stage of the disease according to the TNM classifi cation. False positivity of imaging methods in diagnostics of non-small cell brochogenic carcinoma can contraindicate up to quarter of potentially operable patients (Tab. 3, Ref. 11). Text in PDF www.elis.sk.

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Importance of systemic mediastinal lymphadenectomy in exact staging of bronchogenic carcinoma

Cited by 6 publications

References 1 publication

Treatment of Hemothorax in the Era Of the minimaly Invasive Surgery

Treatment of Hemothorax in the Era Of the minimaly Invasive Surgery

The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection

Importance of histological verification of mediastinal lymphadenopathy in exact staging of non-small cell bronchogenic carcinoma

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