[Radical surgery and lymph node dissection in bronchial carcinoma].

Lymphatic spread of bronchial carcinoma can involve each position in the mediastinum. Localisation of the primary tumor has no influence. Metastatic skipping of topographical lymph node positions is not calculable. Therefore, systematic mediastinal lymph node dissection includes all ipsilateral compartments of the mediastinum. It is also possible to reach contralateral sides. In right-sided thoracotomies, the lymph node dissection is standardised. Mobilising the aortic arch and the large vessels also allows from a left-sided approach a complete mediastinal dissection. The surgical technique is described. Perioperative morbidity does not increase. Systematic mediastinal lymph node dissection is the golden standard for the evaluation of an exact pN stage. The stage-related survival rate is significantly improved. Therefore, the systematic mediastinal lymph node dissection should be a standard in the surgical therapy of bronchial carcinoma.