title: [A Case of Mediastinal Dissection by Video-Assisted Thoracoscopic Surgery (VATS)in a Patient with Mediastinal Nodal Recurrence from Thyroid Carcinoma after Primary Surgery via Median Sternotomy].
abstract: A70 's male was diagnosed with advanced papillary thyroid carcinoma and underwent total thyroidectomy with left lymph node dissection(T4a, N1b, M0, stage IV A). Six years after the surgery, subclavicular and mediastinal lymph node recurrence was observed. Radioiodine therapy was not successful for those lesions. Lymph node dissection was performed via the cervical and transsternal approaches. One year after the second surgery, cervical and mediastinal lymph node recurrence was again observed. We removed the cervical lymph nodes via the cervical approach. One month after cervical dissection, we removed the mediastinal lymph nodes via video-assisted thoracoscopic surgery(VATS). The lymph nodes were relatively easily dissected by VATS under excellent surgical views. Repeat mediastinal dissection via median sternotomy could be associated with significant complications. VATS is expected to reduce the risk of reoperation and enhance surgical outcomes.
authors.affiliation: Dept. of Surgery, Okayama Rosai Hospital.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawai
authors.forename: Ryoma
authors.initials: R
authors.lastname: Sugimoto
authors.forename: Norichika
authors.initials: N
authors.lastname: Iga
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Ikeda
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Yoshida
authors.forename: Naohisa
authors.initials: N
authors.lastname: Waki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishi
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery*; D002291:Carcinoma, Papillary; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000601:surgery; D012008:Recurrence; D056346:Sternotomy; D020775:Thoracic Surgery, Video-Assisted; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000556:secondary* / Q000601:surgery*; D013965:Thyroidectomy