HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Marcin Zielinski Jaroslaw Kuzdzal Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Zielinski, M. Articles by Nabialek, T. Search for Related Content PubMed PubMed Citation Articles by Zielinski, M. Articles by Nabialek, T. Related Collections Lung - cancer Mediastinum

The right upper lobe pulmonary resection performed through the transcervical approach

Marcin Zieliski^a,_*, Juliusz Pankowski^b, ukasz Hauer^a, Jarosaw Kuda^a, Tomasz Nabiaek^c

^a Department of Thoracic Surgery Pulmonary Hospital, Zakopane, Poland
^b Department of Pathology Pulmonary Hospital, Zakopane, Poland
^c Department of Anesthesiology and Intensive Care Pulmonary Hospital, Zakopane, Poland

Received 31 May 2007; accepted 16 July 2007.

^_* Corresponding author. Address: ul. Gadkie 1, 34-500 Zakopane, Poland. Tel.: +48 18 2015045; fax: +48 18 2014632. (Email: marcinz{at}mp.pl).

Objective: Preliminary report: presentation of the new technique of transcervical right upper lobectomy with transcervical extended mediastinal lymphadenectomy (TEMLA) for NSCLC. Methods: Two patients underwent the operation that was performed through the collar incision, with elevation of the sternal manubrium with the mechanical sternal retractor. TEMLA and bilateral mediastinal lymph node excision (stations 1, 2R, 4R, 2L, 4L, 3A, 3P, 7 and 8) and bilateral supraclavicular lymph node excision were performed (frozen section analysis: all nodes negative). The mediastinal pleura was opened and the following structures were dissected in the open fashion with standard surgical instruments and divided with the use of endostaplers: the azygos vein, the upper trunk of the right pulmonary artery, the branch of the superior pulmonary vein to the upper lobe, the upper lobe bronchus, the segment 2 artery, the posterior part of the oblique fissure and the horizontal fissure. The operation was performed with the use of one videothoracoscopic (VTS) port for insertion of 5 mm, 30 degree VTS camera for intraoperative control and for single thoracic drain for the postoperative period. Results: The operative times were 250 and 270 min, respectively; intraoperative blood loss was 110 and 100 ml, respectively. There were no intraoperative complications. The postoperative course was remarkably smooth. The final pathologic report: large cell carcinoma pT2N0M0 and squamous cell carcinoma pT2N0M0, no metastatic changes of 51 and 41 mediastinal and intrapulmonary (stations 10, 11 and 12) and supraclavicular nodes, respectively. Conclusions: This preliminary report indicates possible advantages of the transcervical right upper lobe pulmonary resection including: (1) extremely radical, minimal invasive procedure with no need for utility thoracotomy; (2) dissection performed with standard surgical instruments in the open fashion.

Key Words: Lung cancer • Lobectomy • Mediastinal staging