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Mediastinoscopic staging

Jinbai Miao, Mei Li, Yili Fu, Xiaoxing Hu, Bin Hu, Hui Li
Video-assisted mediastinoscopy (VAM) is the most commonly used invasive method for the preoperative mediastinal staging of lung cancer and for the diagnosis of other mediastinal diseases. However, VAM has the risk of causing life-threatening bleeding consequent to the specific mediastinal anatomy. We adopted the ultrasonic technique for VAM biopsies that can easily distinguish the lymph nodes from the surrounding great vessels and thus makes the procedure easier and safer.
November 2016: Annals of Thoracic Surgery
Sergi Call, Carme Obiols, Ramon Rami-Porta, Juan Carlos Trujillo-Reyes, Manuela Iglesias, Roser Saumench, Guadalupe Gonzalez-Pont, Mireia Serra-Mitjans, Jose Belda-Sanchís
BACKGROUND: The aim of this study was to evaluate the results of video-assisted mediastinoscopic lymphadenectomy (VAMLA) for staging of non-small cell lung cancer (NSCLC). METHODS: This was a prospective observational study of all consecutive VAMLAs performed from January 2010 to April 2015 for staging NSCLC. For left lung cancers, extended cervical videomediastinoscopy was added to explore the subaortic and paraaortic nodes. Patients with negative VAMLA results underwent tumor resection and lymphadenectomy of the remaining nodes...
April 2016: Annals of Thoracic Surgery
Qian-Yun Wang, Jing-Pei Li, Lei Zhang, Nan-Qing Jiang, Zhong-Lin Wang, Xiao-Ying Zhang
OBJECTIVE: The purpose of this study was to detect the feasibility, safety, and effectiveness of mediastinoscopic esophagectomy for early esophageal cancer. METHODS: The clinical data of 194 patients who underwent mediastinoscopic esophagectomy for early esophageal cancer in our center from December 2005 to October 2014 were retrospectively analyzed. RESULTS: All the surgery was performed successfully. The average duration of thoracic surgery was 48...
July 2015: Journal of Thoracic Disease
Seung Hyup Hyun, Hee Kyung Ahn, Myung-Ju Ahn, Yong Chan Ahn, Jhingook Kim, Young Mog Shim, Joon Young Choi
OBJECTIVE: We evaluated the prognostic impact of volume-based assessment by pretreatment (18)F-FDG PET/CT in patients who had clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) treated with neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgical resection. MATERIALS AND METHODS: We reviewed 161 consecutive patients who had stage IIIA-N2 NSCLC treated with neoadjuvant CCRT followed by surgery. In all cases, N2 disease was pathologically confirmed by mediastinoscopic biopsy, endobronchial ultrasound-guided transbronchial needle aspiration, or video-assisted thoracoscopic surgery...
September 2015: AJR. American Journal of Roentgenology
Hiroshi Okumura, Yasuto Uchikado, Masataka Matsumoto, Itaru Omoto, Ken Sasaki, Yoshiaki Kita, Takaaki Arigami, Yoshikazu Uenosono, Akihiro Nakajo, Tetsuhiro Owaki, Shinichiro Mori, Sumiya Ishigami, Shoji Natsugoe
PURPOSE: Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is a useful surgical procedure in esophageal cancer patients who have limited indications for transthoracic operations due to preoperative complications. METHODS: In the last 10 years, 63 patients underwent MATHE at our department. We examined the clinical data of these patients and assessed the indications, postoperative outcomes, and prognostic factors of MATHE. RESULTS: The 5-year overall survival (OS) rate was 53...
August 2015: Langenbeck's Archives of Surgery
Annikka Weissferdt, Neda Kalhor, Cesar A Moran
AIMS: To present six cases of cystic well-differentiated squamous cell carcinoma of the thymus. METHODS AND RESULTS: The patients were six men aged between 48 and 75 years (average: 61.5 years) who were symptomatic with chest pain, shortness of breath, and dyspnoea. Diagnostic imaging showed anterior mediastinal masses, and surgical resection was accomplished in all cases. Grossly, the tumours measured 40-90 mm in greatest diameter (average: 65 mm), and were described as ill-defined lesions with a prominent cystic component and focal areas of haemorrhage and necrosis...
February 2016: Histopathology
Carme Obiols, Sergi Call, Ramón Rami-Porta, Juan Carlos Trujillo-Reyes
Bilateral pulmonary nodules represent a challenge in distinguishing between synchronous bronchogenic carcinomas and metastatic disease. In the case of potentially curable synchronous lung cancer, it is recommended to treat each lesion with curative intent if there is no evidence of mediastinal involvement or extrathoracic disease. In this situation, surgical staging of the mediastinum is recommended. This case shows the utility of a transcervical approach to perform precise mediastinal staging and lymphadenectomy, and to access the pleural cavity to resect a pulmonary nodule...
October 2015: Asian Cardiovascular & Thoracic Annals
Ho Jin Kim, Yong-Hee Kim, Se Hoon Choi, Hyeong Ryul Kim, Dong Kwan Kim, Seung-Il Park
OBJECTIVES: Although video-assisted mediastinoscopic lymphadenectomy (VAMLA) has greatly increased the accuracy of mediastinal staging, its clinical value as a therapeutic tool for complete mediastinal lymph node dissection in the treatment of left-sided lung cancer is not well elucidated. METHODS: We identified the consecutive 649 patients with left-sided lung cancer undergoing minimally invasive pulmonary resection between July 2002 and June 2013. Among them, 225 patients underwent VAMLA combined with pulmonary resection (VAMLA + VATS group), while the remaining 424 patients underwent VATS procedure only (VATS group)...
January 2016: European Journal of Cardio-thoracic Surgery
Cheng Ji, Bin Zhang, Weidong Zhu, Chunhua Ling, Xudong Hu, Yanbin Chen, Jianan Huang, Lingchun Guo, Haodong Xu
Accurate lymph nodal staging of lung cancer is critical for determining the treatment options. With the help of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG-PET/CT), the clinician can rule out/in the regional lymph nodes positive for metastasis in the patients with lung cancer in a majority of cases. However, a small proportion of cases with false positivity of metastasis have been reported. Transbronchial needle aspirations and mediastinoscopic biopsies are still necessary to determine whether enlarged hypermetabolic mediastinal lymph nodes are positive for lung cancer metastasis...
2014: International Journal of Clinical and Experimental Pathology
Wenlong Shao, Jun Liu, Wehua Liang, Hanzhang Chen, Shuben Li, Weiqiang Yin, Xin Zhang, Jianxing He
OBJECTIVE: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery (VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery. METHODS: A total of 51 patients with radiologically or mediastinoscopically confirmed stage IIIA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment...
August 2014: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Biruta Witte, Martin Hürtgen
Systematic mediastinal lymphadenectomy is usually done at thoracotomy together with lung resection. It is a prerequisite for accurate nodal staging and has an impact on survival. With the introduction of neoadjuvant therapy for stage III lung carcinoma, mediastinal staging before therapy became more important. Video-assisted mediastinoscopic lymphadenectomy (VAMLA) is a minimally invasive technique of systematic mediastinal dissection that equals radicality of open lymphadenectomy, and can be carried out before neoadjuvant treatment and independently from tumour resection...
January 1, 2007: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Catharine Ann Dhaliwal, Timothy D Andrews, William S Walker, William A Wallace
INTRODUCTION: Despite the advent of PET scanning and endoscopic minimally invasive methods of sampling mediastinal lymph nodes, surgical assessment, particularly by mediastinoscopy, remains an important tool for staging non-small cell lung cancer. METHODS: We carried out a retrospective review of mediastinoscopic lymph node biopsies taken at The Royal Infirmary of Edinburgh between 1996 and 2006 and performed additional histological investigations on select cases...
January 2014: Journal of Clinical Pathology
Biruta Witte, Michael Wolf, Hubertus Hillebrand, Elke Kriegel, Martin Huertgen
OBJECTIVES: To describe the diagnostic value of selective extended cervical mediastinoscopy (ECM) in combination with video-assisted mediastinoscopic lymphadenectomy (VAMLA) in mediastinal staging of potentially resectable left-sided lung carcinoma. METHODS: Institutional report on 110 ECM procedures indicated for enlarged lymph nodes within the aorto-pulmonary (AP) zone on computed tomography. Staging sensitivity, negative predictive value (NPV) and specificity of ECM, combined VAMLA and ECM, VAMLA alone and systematic dissection for lung resection via left-sided video-assisted thoracoscopic surgery (VATS) or thoracotomy were calculated from a subset of 92 patients with left-sided lung carcinoma...
January 2014: European Journal of Cardio-thoracic Surgery
Akif Turna, Ahmet Demirkaya, Serkan Ozkul, Buge Oz, Atilla Gurses, Kamil Kaynak
OBJECTIVES: We aimed to analyze the accuracy of video-assisted mediastinoscopic lymphadenectomy (VAMLA) as a tool for preoperative staging and the impact of the technique on survival in patients with non-small cell lung cancer (NSCLC) undergoing pulmonary resection. METHODS: Between May 2006 and December 2010, 433 patients underwent pulmonary resection for NSCLC, 89 (21%) had VAMLA before resection and 344 (79%) had standard mediastinoscopy. The patients who had negative VAMLA/mediastinoscopy results underwent anatomic pulmonary resection and systematic lymph node dissection...
October 2013: Journal of Thoracic and Cardiovascular Surgery
Gustavo Reis, Vânia Sacramento, Maria José Simões, Ivan Bravio, Pedro Baptista, Eugénia Pinto, Elvira Camacho, Fernando Martelo
A bronchogenic cyst is a congenital malformation originating from the ventral primitive gut. It may be located in the mediastinum or in the lung parenchyma. Its location depends on the stage of gestation in which it developed. Despite being a histological benign tumor, many authors recommend its complete excision in order to obtain histological confirmation and to prevent future complications. The traditional approaches for excision are thoracotomy or video-assisted thoracoscopic surgery (VATS). However, a minimally invasive approach through vídeomediastinoscopy constitutes a valid alternative in selected cases...
July 2011: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Hee Kyung Ahn, Yoon-La Choi, Joung Ho Han, Yong Chan Ahn, Kwhanmien Kim, Jhingook Kim, Young Mog Shim, Sang-Won Um, Hojoong Kim, O Jung Kwon, Jong-Mu Sun, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn
Epidermal growth factor receptor (EGFR) mutation in non-small cell lung cancer (NSCLC) is a strong predictive factor for a favorable response to EGFR tyrosine kinase inhibitors, however, its prognostic role in locally advanced stage is unclear. The aim of this study was to analyze the association of EGFR mutational status and clinical outcome after neoadjuvant chemoradiotherapy (CRT) followed by surgical resection in mediastinoscopically proven N2(+) NSCLC patients. We retrospectively identified 168 patients diagnosed between 1998 and 2006...
March 2013: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Marcin Zieliński
This article describes in detail the operative technique of the new surgical methods, video-assisted mediastinoscopic lymphadenectomy (VAMLA) and transcervical extended mediastinal lymphadenectomy (TEMLA). Both techniques enable the removal of the mediastinal nodes with the surrounding fatty tissue. VAMLA and TEMLA have very high diagnostic yield and can be combined with minimally invasive video-assisted lobectomy.
May 2012: Thoracic Surgery Clinics
Ying Chen, Bo Ping, Long-fu Wang, Li-qing Feng, Wei-ping Xu, Jia-wen Wu, Wen-tao Yang, Xiao-yan Zhou, Xu Cai, Hong Hu, Hai-quan Chen, Lei Shen
OBJECTIVE: To evaluate the role of cytopathology in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for lung tumor diagnosis and staging. METHODS: Two-hundred consecutive cases of lung tumor with EBUS-TBNA performed during the period from April, 2009 to September, 2010 in Shanghai Cancer Hospital were retrospectively reviewed. The cytologic diagnoses were categorized as non-diagnostic, negative, suspicious and malignant. When available, cell block preparation and immunohistochemistry were performed...
January 2012: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Ming-Xiang Feng, Hao Wang, Yi Zhang, Li-Jie Tan, Zheng-Lang Xu, Wang Qun
OBJECTIVE: Minimally invasive esophagectomy (MIE) has been widely applied for esophageal carcinoma treatment. Thoracoscope-assisted transthoracic esophagectomy (TATTE) and mediastinoscope-assisted transhiatal esophagectomy (MATHE) are two kinds of MIE. The objective of this study is to compare these two methods with respect to surgical safety and survival. METHODS: Single-institution experience with MATHE and TATTE was analyzed to assess morbidity, adequacy of tumor clearance, and survival...
June 2012: Surgical Endoscopy
Adnan Sayar, Necati Citak, Muzaffer Metin, Akif Turna, Atilla Pekçolaklar, Abdulaziz Kök, Nur Urer, Alper Celikten, Zeynep Nilgün Ulukol, Atilla Gürses
PURPOSE: We compared the efficacy and complications of video-assisted mediastinoscopy (VAM) and video-assisted mediastinal lymphadenectomy (VAMLA) for mediastinal staging of lung cancer. METHODS: Between March 2006 and July 2008, a total of 157 patients with non-small-cell lung cancer (NSCLC) underwent VAM (n = 113, 72%) or VAMLA (n = 44, 28%). We studied them retrospectively. Data for the operating time, node stations sampled/dissected, number of biopsies, and the patients who were pN0 by mediastinoscopy and underwent thoracotomy were collected...
December 2011: General Thoracic and Cardiovascular Surgery
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