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DOI: 10.1055/s-2006-924570
© Georg Thieme Verlag KG Stuttgart · New York
Finding the Limit between Station 2 and Station 4 during Right-Sided Thoracotomy
Publication History
Received June 19, 2006
Publication Date:
05 April 2007 (online)
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Introduction
Mediastinal lymph node dissection is a key part of resection for lung cancer to obtain a radical resection and accurate staging. On the right side, the upper limit of the paratracheal region is represented by lymph node station 2, which is separated from station 4 by a line drawn tangentially to the upper margin of the aortic arch [[1]]. This line is not visible during mediastinal dissection. Therefore, during right thoracotomy, the definition of station 2 is arbitrary. As the involvement of the nodal station 2 has been considered to be a marker for incomplete resection in many lung cancer trials [[2]], the precise definition of the lower limit of this station is important.
Recently, we developed an intraoperative technique to assess this limit properly during mediastinoscopy [[3]]. We modified this simple technique for use during mediastinal dissection through a right thoracotomy.
References
- 1 Mountain C F, Dresler C M. Regional lymph node classification for lung cancer staging. Chest. 1997; 111 1718-1723
- 2 The Lung Cancer Study Group . The benefit of adjuvant treatment for resected locally advanced non-small cell lung cancer. J Clin Oncol. 1988; 6 9-17
- 3 Leo F, Venissac N, Pop D, Khelef S, Mouroux J. How to find the limit between station 2 and station 4 during mediastinoscopy. Ann Thorac Surg. 2006; 81 1150-1152
- 4 Naruke T, Suemasu K, Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg. 1978; 76 832-839
- 5 Tisi G M. Clinical staging of primary lung cancer. Am Rev Respir Dis. 1983; 127 659-664
MD Francesco Leo
European Institute of Oncology
Division of Thoracic Surgery
Via Ripamonti, 435
20141 Milan
Italy
Fax: + 39 02 57 48 96 98
Email: francesco.leo@ieo.it