Müller M R, Watzka S B
Abteilung für Thoraxchirurgie, Otto-Wagner-Spital, Wien.
Pneumologie. 2015 Mar;69(3):165-76. doi: 10.1055/s-0034-1391100. Epub 2015 Mar 6.
Proper staging of lung cancer represents the basis for any stage-adapted and optimized treatment. This is today implemented in specialized centers mainly through the use of modern imaging methods and minimally-invasive measures. However, general thoracic surgery has a role not only in the therapeutic management of lung cancer, but offers additional staging information whenever endoscopic or interventional methods fail to achieve representative tissue biopsies of mediastinal lymph nodes or suspect lesions for conclusive diagnosis. The thoracic surgical armentarium comprises of cervical or extended mediastinoscopy, video-assisted mediastinal lymphadenectomy (VAMLA), anterior mediastinotomy (Chamberlain procedure) and video-thoracoscopy (VATS). Indications for any invasive diagnostic methods always have to respect a therapeutic benefit for the patient.
肺癌的准确分期是任何基于分期的适应性和优化治疗的基础。如今，这主要在专业中心通过使用现代成像方法和微创措施来实现。然而，普通胸外科不仅在肺癌的治疗管理中发挥作用，而且在内镜或介入方法未能获取纵隔淋巴结或可疑病变的代表性组织活检以进行确诊时，还能提供额外的分期信息。胸外科手术器械包括颈部或扩大纵隔镜检查、电视辅助纵隔淋巴结清扫术（VAMLA）、前纵隔切开术（张伯伦手术）和电视胸腔镜检查（VATS）。任何侵入性诊断方法的适应症都必须始终考虑对患者的治疗益处。
