European Journal of Cardio-Thoracic Surgery, Vol 9, 544-547, Copyright © 1995 by European Association for Cardio-thoracic Surgery
Thoracoscopic mediastinal lymph node dissection: an experimental study in pigs
PC Cassina, M Julke and W Weder
Department of Surgery, University Hospital, Zurich, Switzerland.
Thoracoscopic lobectomy is feasible and can be performed correctly in terms
of anatomy. Its application in bronchial carcinoma is often criticized,
partly because of incomplete mediastinal lymph node dissection (MLD). We
therefore developed the technique and studied the completeness of MLD in an
animal experiment. Ten pigs were anesthetized and intubated with a
double-lumen tube and the left lung was excluded from ventilation. Four
trocars were inserted. Using a modified endo- Babcock clamp for traction we
resected all ipsilateral tracheobronchial, pretracheal and paratracheal and
paraesophageal lymph nodes (LNs) as well as nodes in the aortopulmonary
window. An average of 19 +/- 5 mediastinal LNs were removed. Macroscopic
control through a thoracotomy did not show any residual LNs at the site of
operation. Complete resection of all ipsilateral LNs in the paratracheal
and paraesophageal region as well as the aortopulmonary window can be
performed thoracoscopically in pigs. This may offer further perspectives in
the thoracoscopic treatment of bronchial carcinoma.