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Eur J Cardiothorac Surg 2002;21:348-351
© 2002 Elsevier Science NL

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Radical video-assisted mediastinoscopic lymphadenectomy (VAMLA) – technique and first results

^a Department of Thoracic Surgery, Centre for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Solitudestrasse 18, D-70839 Gerlingen, Germany
^b Institute of Pathology, Robert-Bosch-Hospital, Auerbachstrasse 110, D-70341 Stuttgart, Germany

Received 21 November 2000; received in revised form 21 September 2001; accepted 20 November 2001.

* Corresponding author. Tel.: +49-7156-203-2258; fax: +49-7156-203-2003
e-mail: martin{at}huertgen-huertgen.de

Exact pretherapeutic lymph node staging of lung cancer is of special importance for selecting patients for neoadjuvant therapy or for video-assisted thoracoscopic resection. Staging is usually performed by computerized tomography scan and mediastinoscopy. However, these methods do not reach the accuracy of open nodal dissection. Therefore, we developed a technique of radical video-assisted mediastinoscopic lymphadenectomy (VAMLA). In a prospective study, all VAMLA procedures were documented. Lymph nodes were counted and compared to open lymphadenectomy. In 40/46 patients, radical paratracheal and subcarinal dissection was achieved by VAMLA. An average number of 20.7 (5–60, SD 11.1) nodes was gained. This is comparable to our data from open lymphadenectomy.

Key Words: Mediastinoscopy • Staging of lung cancer • Video-assisted surgery • Lung neoplasm • Lymphadenectomy

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