[Ingenuity of Lymph Node Dissection Reduction for Minimally Invasive Lung Cancer Surgery].

ABSTRACT

Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is accurate staging. In clinical early-stage non-small cell lung cancer (NSCLC), if the nodes are negative, complete mediastinal lymph node dissection might be omitted. Selective mediastinal dissection for clinico-surgical stage I NSCLC proved to be as effective as complete dissection. When lymph node metastasis was observed, segmentectomy was converted to lobectomy. Sentinel node( SN) identification is useful to determine the final indication of minimally invasive surgery by targeting the lymph nodes needed for intraoperative frozen section diagnosis. Many evidences suggest that prognosis of NSCLC with lymph node micrometastases (LNMM) is poor compared with those without LNMM. Evaluation of micrometastases of all dissected lymph nodes may be substituted by evaluating micrometastases of SNs. SN identification is important to the efficiency of micrometastases detection of intraoperative diagnosis. To perform a minimally invasive surgery, evaluation of lymph nodes micrometastases in SN is required.