Thorac Cardiovasc Surg 2007; 55(3): 203-204
DOI: 10.1055/s-2006-924570
Short Communications

© Georg Thieme Verlag KG Stuttgart · New York

Finding the Limit between Station 2 and Station 4 during Right-Sided Thoracotomy

F. Leo1 , D. Galetta1 , G. Bonomo2 , L. Spaggiari1 , 3
  • 1European Institute of Oncology, Division of Thoracic Surgery, Milan, Italy
  • 2European Institute of Oncology, Radiology Department, Milan, Italy
  • 3University of Milan, School of Medicine, Milan, Italy
Further Information

Publication History

Received June 19, 2006

Publication Date:
05 April 2007 (online)

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

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  • 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