How to deal with complicate hilar or interlobar lymphadenopathy during video-assisted thoracoscopic surgery lobectomy

Zhenrong Zhang, Deruo Liu, Yongqing Guo, Tong Bao, Fei Xiao, Qianli Ma, Chaoyang Liang


Background: Lobectomy via video-assisted thoracoscopic surgery (VATS) is steadily becoming more commonplace. Concerns regarding oncologic effectiveness are focused on the ability to achieve complete lymphadenectomy using VATS technique. Effective VATS lymphadenectomy depends on a comprehensive understanding of the anatomy.
Methods: In this report, we would provide comprehensive surgical techniques on the management of complicate hilar or interlobar lymphadenectomy via VATS.
Results: Two cases of VATS lymphadenectomy were shown in this study. Various techniques have been adapted for lymphadenectomy with VATS. VATS lymphadenectomy is equivalent to dissection via thoracotomy when performed by experienced surgeons. Thoracic surgeons should keep in mind that to handle the sophisticated lymph node (LN) situation could be a tedious and rough job.
Conclusions: Lymphadenectomy is a crucial element of staging for early stage non-small cell lung cancer patients. During VATS lobectomy, lymphadenectomy must be performed safely and effectively, with oncologic results comparable with those of open procedures.