Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery

This study aims to introduce an optimized method named "non-grasping en bloc mediastinal lymph node dissection (MLND)" through video-assisted thoracoscopic surgery (VATS). Between February 2009 and July 2013, 402 patients with clinical stage I non-small cell lung cancer (NSCLC) underwent &...

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Veröffentlicht in:BMC surgery 2015-04, Vol.15 (1), p.38-38, Article 38
Hauptverfasser: Liu, Chengwu, Pu, Qiang, Guo, Chenglin, Xiao, Zhilan, Mei, Jiandong, Ma, Lin, Zhu, Yunke, Liao, Hu, Liu, Lunxu
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container_end_page 38
container_issue 1
container_start_page 38
container_title BMC surgery
container_volume 15
creator Liu, Chengwu
Pu, Qiang
Guo, Chenglin
Xiao, Zhilan
Mei, Jiandong
Ma, Lin
Zhu, Yunke
Liao, Hu
Liu, Lunxu
description This study aims to introduce an optimized method named "non-grasping en bloc mediastinal lymph node dissection (MLND)" through video-assisted thoracoscopic surgery (VATS). Between February 2009 and July 2013, 402 patients with clinical stage I non-small cell lung cancer (NSCLC) underwent "non-grasping en bloc MLND" conducted by one surgical team. Target lymph nodes (LNs) were exposed following non-grasping strategy with simple combination of a metal endoscopic suction and an electrocoagulation hook or an ultrasound scalpel. In addition, dissection was performed following a stylized three-dimensional process according to the anatomic features of each station. Clinical and pathological data were prospectively collected and retrospectively reviewed. The postoperative morbidity and mortality were 17.4% (70/402) and 0.5% (2/402), respectively. The total number of LNs (N1 + N2) was 16.0 ± 5.9 (range of 5-52), while the number of N2 LNs was 9.5 ± 4.0 (range of 3-23). The incidences of postoperative upstaging from N0 to N1 and N2 disease were 7.7% and 12.2%, respectively. Non-grasping en bloc MLND enables en bloc dissection of mediastinal LNs with comparable morbidity and oncological efficacy while saving troubles of excessive interference of instruments and potential damage to the target LN.
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Between February 2009 and July 2013, 402 patients with clinical stage I non-small cell lung cancer (NSCLC) underwent "non-grasping en bloc MLND" conducted by one surgical team. Target lymph nodes (LNs) were exposed following non-grasping strategy with simple combination of a metal endoscopic suction and an electrocoagulation hook or an ultrasound scalpel. In addition, dissection was performed following a stylized three-dimensional process according to the anatomic features of each station. Clinical and pathological data were prospectively collected and retrospectively reviewed. The postoperative morbidity and mortality were 17.4% (70/402) and 0.5% (2/402), respectively. The total number of LNs (N1 + N2) was 16.0 ± 5.9 (range of 5-52), while the number of N2 LNs was 9.5 ± 4.0 (range of 3-23). The incidences of postoperative upstaging from N0 to N1 and N2 disease were 7.7% and 12.2%, respectively. Non-grasping en bloc MLND enables en bloc dissection of mediastinal LNs with comparable morbidity and oncological efficacy while saving troubles of excessive interference of instruments and potential damage to the target LN.</description><identifier>ISSN: 1471-2482</identifier><identifier>EISSN: 1471-2482</identifier><identifier>DOI: 10.1186/s12893-015-0025-1</identifier><identifier>PMID: 25884998</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Female ; Humans ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Lymph Node Excision - methods ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Technical Advance ; Thoracic Surgery, Video-Assisted - methods ; Treatment Outcome</subject><ispartof>BMC surgery, 2015-04, Vol.15 (1), p.38-38, Article 38</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Liu et al.; licensee BioMed Central. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-a9d2edd1d69dd1c8a718b33cac0766edbf4b1476711388c062c3348daae7e11f3</citedby><cites>FETCH-LOGICAL-c396t-a9d2edd1d69dd1c8a718b33cac0766edbf4b1476711388c062c3348daae7e11f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392751/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392751/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,27907,27908,53774,53776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25884998$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Chengwu</creatorcontrib><creatorcontrib>Pu, Qiang</creatorcontrib><creatorcontrib>Guo, Chenglin</creatorcontrib><creatorcontrib>Xiao, Zhilan</creatorcontrib><creatorcontrib>Mei, Jiandong</creatorcontrib><creatorcontrib>Ma, Lin</creatorcontrib><creatorcontrib>Zhu, Yunke</creatorcontrib><creatorcontrib>Liao, Hu</creatorcontrib><creatorcontrib>Liu, Lunxu</creatorcontrib><title>Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery</title><title>BMC surgery</title><addtitle>BMC Surg</addtitle><description>This study aims to introduce an optimized method named "non-grasping en bloc mediastinal lymph node dissection (MLND)" through video-assisted thoracoscopic surgery (VATS). 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Non-grasping en bloc MLND enables en bloc dissection of mediastinal LNs with comparable morbidity and oncological efficacy while saving troubles of excessive interference of instruments and potential damage to the target LN.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymph Node Excision - methods</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Mediastinum</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Retrospective Studies</subject><subject>Technical Advance</subject><subject>Thoracic Surgery, Video-Assisted - methods</subject><subject>Treatment Outcome</subject><issn>1471-2482</issn><issn>1471-2482</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptUU1r3TAQFKWlSdP-gF6KoJdenHolWZYvhRD6BSG5pGchS2s_tbbkSnbg_fvo8dKQQBGsltXMsKMh5D3U5wBKfs7AVMerGpqqrllTwQtyCqKFignFXj7pT8ibnH_XNbSqaV6TE9YoJbpOnZI_1zFUYzJ58WGkGGg_RUtndN7k1Qcz0Wk_LzsaokPqfM5oVx8DHWKid95hrEzOPq_o6LqLydiYbVy8pdNW9KwJFhPNWxox7d-SV4OZMr57uM_Ir29fby9_VFc3339eXlxVlndyrUznGDoHTnalWmVaUD3n1ti6lRJdP4i-OJMtAFfK1pJZzoVyxmCLAAM_I1-OusvWFycWw5rMpJfkZ5P2Ohqvn78Ev9NjvNOCd6xtoAh8ehBI8e-GedWzzxanyQSMW9YgWyFV-UtRoB-P0NFMqH0YYlG0B7i-aAQIDqyRBXX-H1Q5DmdvY8DBl_kzAhwJNsWcEw6P20OtD9nrY_a6ZK8P2evD1h-e2n5k_Aub3wMCvKxX</recordid><startdate>20150408</startdate><enddate>20150408</enddate><creator>Liu, Chengwu</creator><creator>Pu, Qiang</creator><creator>Guo, Chenglin</creator><creator>Xiao, Zhilan</creator><creator>Mei, Jiandong</creator><creator>Ma, Lin</creator><creator>Zhu, Yunke</creator><creator>Liao, Hu</creator><creator>Liu, Lunxu</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150408</creationdate><title>Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery</title><author>Liu, Chengwu ; Pu, Qiang ; Guo, Chenglin ; Xiao, Zhilan ; Mei, Jiandong ; Ma, Lin ; Zhu, Yunke ; Liao, Hu ; Liu, Lunxu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-a9d2edd1d69dd1c8a718b33cac0766edbf4b1476711388c062c3348daae7e11f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymph Node Excision - methods</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Mediastinum</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Retrospective Studies</topic><topic>Technical Advance</topic><topic>Thoracic Surgery, Video-Assisted - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Chengwu</creatorcontrib><creatorcontrib>Pu, Qiang</creatorcontrib><creatorcontrib>Guo, Chenglin</creatorcontrib><creatorcontrib>Xiao, Zhilan</creatorcontrib><creatorcontrib>Mei, Jiandong</creatorcontrib><creatorcontrib>Ma, Lin</creatorcontrib><creatorcontrib>Zhu, Yunke</creatorcontrib><creatorcontrib>Liao, Hu</creatorcontrib><creatorcontrib>Liu, Lunxu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Chengwu</au><au>Pu, Qiang</au><au>Guo, Chenglin</au><au>Xiao, Zhilan</au><au>Mei, Jiandong</au><au>Ma, Lin</au><au>Zhu, Yunke</au><au>Liao, Hu</au><au>Liu, Lunxu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery</atitle><jtitle>BMC surgery</jtitle><addtitle>BMC Surg</addtitle><date>2015-04-08</date><risdate>2015</risdate><volume>15</volume><issue>1</issue><spage>38</spage><epage>38</epage><pages>38-38</pages><artnum>38</artnum><issn>1471-2482</issn><eissn>1471-2482</eissn><abstract>This study aims to introduce an optimized method named "non-grasping en bloc mediastinal lymph node dissection (MLND)" through video-assisted thoracoscopic surgery (VATS). Between February 2009 and July 2013, 402 patients with clinical stage I non-small cell lung cancer (NSCLC) underwent "non-grasping en bloc MLND" conducted by one surgical team. Target lymph nodes (LNs) were exposed following non-grasping strategy with simple combination of a metal endoscopic suction and an electrocoagulation hook or an ultrasound scalpel. In addition, dissection was performed following a stylized three-dimensional process according to the anatomic features of each station. Clinical and pathological data were prospectively collected and retrospectively reviewed. The postoperative morbidity and mortality were 17.4% (70/402) and 0.5% (2/402), respectively. The total number of LNs (N1 + N2) was 16.0 ± 5.9 (range of 5-52), while the number of N2 LNs was 9.5 ± 4.0 (range of 3-23). The incidences of postoperative upstaging from N0 to N1 and N2 disease were 7.7% and 12.2%, respectively. Non-grasping en bloc MLND enables en bloc dissection of mediastinal LNs with comparable morbidity and oncological efficacy while saving troubles of excessive interference of instruments and potential damage to the target LN.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25884998</pmid><doi>10.1186/s12893-015-0025-1</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - pathology
Carcinoma, Non-Small-Cell Lung - surgery
Female
Humans
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Lymph Node Excision - methods
Lymphatic Metastasis
Male
Mediastinum
Middle Aged
Neoplasm Staging
Retrospective Studies
Technical Advance
Thoracic Surgery, Video-Assisted - methods
Treatment Outcome
title Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery
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