Video-assisted mediastinoscopic lymphadenectomy: technique and first results

Abstract

Video-assisted mediastinal lymphadenectomy (VAMLA) has been introduced into our clinical practice as a surgical method for N-staging of non-small cell lung cancer (NSCLC) since 2017. In this paper, we presented the technique of VAMLA, analyzed our experience and compared the results of the intervention with previously published data from other authors.

Material and methods. The study included materials from the examination and treatment of 56 patients with NSCLC who underwent VAMLA as part of the preoperative determination of the N-stage.

Results. The average intervention time was 113±25 minutes. Each patient had 18.7±7.3; Me=18 (14–24) lymph nodes removed, from an average of 4.3±0.7 stations. The lymph nodes of groups 2R, 4R, 2L, 4L, and 7 were removed in 93, 100, 24, 100, and 100%, respectively. Biopsy of available nodes of group 10R was performed in 19.6% (11/56). 7  patients (12.5%) developed dysphonia after surgery. The learning curve of the new method in our experience was 30 operations. After VAMLA there were no missed metastases in the accessible areas of the mediastinum.

Conclusion. VAMLA is an effective and safe therapeutic and diagnostic intervention that demonstrates a consistently high volume of bilateral mediastinal lymphadenectomy.