title: Thoracoscopic right upper mediastinal dissection for left lung cancer.
abstract: 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.
authors.affiliation: Second Department of Surgery, Fukuoka University School of Medicine, 7-45-1 Jyonannku, Nanakuma, Fukuoka 814-0180, Japan.
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Kawahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Yasuteru
authors.initials: Y
authors.lastname: Yoshinaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoneda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shirakusa
mesh_terms: 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