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The Annals of Thoracic Surgery, Vol 55, 961-966, Copyright © 1993 by The Society of Thoracic Surgeons
EC Bollen, CJ van Duin, PH Theunissen, BE v.t Hof-Grootenboer and GH Blijham
A study was performed to investigate the morbidity of mediastinal lymph
node dissection (MND) and to establish its contribution to the accuracy of
staging in surgically treated non-small cell lung cancer. Between 1988 and
the middle of 1991 a systematic sampling of mediastinal lymph nodes was
done in 20 patients and a MND was carried out in 65 patients. Data from
these patients were compared with those from a control group of 70 patients
operated on in 1986 and 1987, who would have had MND if they had been
treated in the years after 1988. The groups were comparable according to
important clinical characteristics. There was a significantly greater fluid
production via the drains in the groups with systematic sampling and MND,
compared with the controls. Volume of blood lost during the operation and
number of units blood transfused perioperatively were not significantly
different between the groups. Three lesions of the recurrent laryngeal
nerve and two episodes of chylothorax were observed, all probably caused by
MND. The discovery ratio for N2 disease in the MND and systematic sampling
groups together compared with the control group was 2.1, with a 95%
confidence interval from 1.04 to 4.2.
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Mediastinal lymph node dissection in resected lung cancer: morbidity and accuracy of staging
Department of Surgery, De Wever Hospital, Heerlen, The Netherlands.
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