Thoracoscopic right upper mediastinal dissection for left lung cancer.
OBJECTIVE
In left lung cancer, left and right mediastinum lymphatic spread occur equally frequently. We evaluated the safety and effectiveness of thoracoscopic right upper mediastinal dissection, implemented prior to left lung resection for left lung cancer.


METHODS
Between January 1999 and May 2000, 17 patients with left lung cancer underwent thoracoscopic right upper mediastinal dissection prior to resection of the left lung and left mediastinal dissection for left lung cancer. These patients had either enlarged left hilar or bilateral mediastinal nodes, or either a tumor at least 3 cm in diameter or tumor extension to the hilum, mediastinum, or chest wall. Tumor and lymph nodes were examined with hematoxylin and eosin and immunohistochemical staining of cytokeratin for micrometastasis.


RESULTS
In 3 patients (17.6%), metastasis occurred in right paratracheal nodes. The 30-day mortality was 0% and morbidity 35.3% (6/17). Postoperative complications occurred in 3 of 4 patients (75%) undergoing induction chemotherapy, but none were lethal.


CONCLUSIONS
Thoracoscopic right upper mediastinal dissection is safe and feasible in treating advanced left lung cancer.
Kawahara
Katsunobu
K
Second Department of Surgery, Fukuoka University School of Medicine, 7-45-1 Jyonannku, Nanakuma, Fukuoka 814-0180, Japan.
Shiraishi
Takeshi
T
Iwasaki
Akinori
A
Yoshinaga
Yasuteru
Y
Yamamoto
Satoshi
S
Yoneda
Satoshi
S
Shirakusa
Takayuki
T
D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000601:surgery*; D008875:Middle Aged; D013906:Thoracoscopy