Abstract
The extent of lymph node dissection is one of the most critical issues discussed in the context of surgical treatment for non-small cell lung cancer (NSCLC), as the appropriate scope of intervention on the regional lymphatic system determines the accuracy of the final tumor stage, the need for adjuvant therapy, and contributes to improved long-term outcomes in lung cancer treatment. The most accurate pathological N stage can be established through bilateral mediastinal lymphadenectomy, for which the minimally invasive technique of video-assisted mediastinal lymphadenectomy (VAMLA) can be used in modern thoracic surgery. Doing VAMLA and anatomical lung resection under a single anesthesia has been described in only a few publications. The aim of our observational study was to evaluate the efficacy and safety of such a simultaneous intervention. Based on a detailed analysis of intra- and postoperative parameters from 100 patients, we found that performing VAMLA together with anatomical lung resection achieves high accuracy in final N-staging by removing a large number of lymph node groups for histological examination. Moreover, this simultaneous approach is not associated with any worsening in the early postoperative period, and is consistent with published results of standard anatomical resections for NSCLC. Thus, simultaneous performance of VAMLA and anatomical lung resection appears to be a promising option for surgical intervention in resectable NSCLC, especially for left-sided tumors, and requires further investigation via comparative studies.