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[术前纵隔镜检查对纵隔淋巴结的分离评估作为肺癌外科治疗中的一种解剖措施]

[An assessment of the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination as a dissecting measure in the surgical treatment of lung cancer].

作者信息

Nakanishi R, Shirakusa T, Hirao D, Yasugawa H, Noda Y, Tokunaga H, Takada T

机构信息

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1992 Sep;40(9):1707-13.

PMID:1402187
Abstract

The availability of the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination as a dissecting measure was analyzed according to prognosis retrospectively because mediastinal lymph nodes dissection is made with ease and certainty after the examination. The separation by mediastinoscopic examination did not have an impact on the mediastinal lymph nodes dissection for carcinoma of the left lung and superior mediastinal lymph nodes metastases (# 1-4), but an influence on the dissection for carcinoma of the right lung and middle and lower mediastinal lymph nodes metastases (# 5-9). This result showed the existence of occult metastases and the good effects caused by the separation of mediastinal lymph nodes. In the histological type, the effects were present in squamous cell carcinoma and p-N0 adenocarcinoma, but it was concluded that the prognosis in adenocarcinoma was associated with other factors rather than lymph node metastasis. Therefore, it can be seen that the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination is available as a dissecting measure.

摘要

由于术前纵隔镜检查后进行纵隔淋巴结清扫轻松且确定,故对术前纵隔镜检查作为一种清扫手段分离纵隔淋巴结的情况按预后进行回顾性分析。纵隔镜检查分离对左肺癌及上纵隔淋巴结转移(#1 - 4)的纵隔淋巴结清扫无影响,但对右肺癌及中、下纵隔淋巴结转移(#5 - 9)的清扫有影响。这一结果显示存在隐匿性转移以及纵隔淋巴结分离所带来的良好效果。在组织学类型方面,鳞状细胞癌和p - N0腺癌有效果,但得出腺癌的预后与其他因素而非淋巴结转移相关的结论。因此,可以看出术前纵隔镜检查分离纵隔淋巴结可作为一种清扫手段。

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