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Objective To explore the method and essential procedure for lymph node eradication during video-assisted thoracoscopic lobectomy in patients with lung cancer. Methods Two hundred and sixty-four patients with lung cancer underwent thoracoscopic lobectomy and lymph node eradication from April 2007 to April 2012 in General Hospital of PLA. In 144 cases of right lung cancer, the eradicated lymph nodes included groups 2, 3, 4R, 7, 8, 9, 10 and 11. In 120 cases of left lung cancer, the eradicated lymph nodes included groups 5 to 11. The mediastinal lymph nodes were removed en bloc according to the anatomic distribution. The clinical data and pathological results of all patients were analyzed retrospectively. Results The operation was successfully completed in all the patients, the operation time was 162.4±35.8 minutes, and the blood loss was 129.3±46.3ml. Three patients suffered from postoperative chylothorax, and they recovered after conservative treatment. Two patients suffered from the complication of hoarse voice, and one of them recovered 2 months later, and another did not recover. 8.7±1.2 and 10.6±1.4 lymph nodes of N1 and N2 were removed in patients with right lung cancer, and 8.2±1.4 and 9.2±1.3 in patients with left lung cancer. According to anatomic distribution, the number of removed lymph nodes from right superior mediastinum (including groups 2, 3 and 4R) was 4.2±0.9, that of left superior mediastinum (including groups 5 and 6) was 2.8±1.0, that of inferior mediastinum (including groups 8 and 9) was 2.1±0.7, and that of group 7 was 3.3±1.8. Metastasis of N1 lymph nodes was found in 64 patients (24%) and that of N2 in 21 patients (8%), and in 3 of them only lymph nodes of N2 were found to have metastasis but none in N1 lymph nodes. Conclusion In video-assisted thoracoscopic lobectomy, lymph node eradication could be accomplished in patients with lung cancer. En bloc lymph node eradication according to anatomic distribution was safe and reliable. |
