RADICALITY AND LYMPH-NODE DISSECTION IN B RONCHIAL-CARCINOMA

Lymphatic spread of bronchial carcinoma can involve each position in t he mediastinum. Localisation of the primary tumor has no influence. Me tastatic skipping of topographical lymph node positions is not calcula ble. Therefore, systematic mediastinal lymph node dissection includes all ipsilateral compartments of the mediastinum. It is also possible t o reach contralateral sides. In right-sided thoracotomies, the lymph n ode dissection is standardised. Mobilising the aortic arch and the lar ge vessels also allows from a left-sided approach a complete mediastin al dissection. The surgical technique is described. Perioperative morb idity does not increase. Systematic mediastinal lymph node dissection is the golden standard for the evaluation of an exact pN stage. The st age-related survival rate is significantly improved. Therefore, the sy stematic mediastinal lymph node dissection should be a standard in the surgical therapy of bronchial carcinoma.