Features and complications of videomediastinoscopy in lung cancer

Medical Review (Med. pregled), 2024, 60(3), 39-43.

A. Ivanov, D. Mitev, N. Dragnev

Department of Thoracic Surgery, MHAT Heart and Brain – Burgas

Abstract. Lung cancer is the leading cause of death among cancer cases worldwide. It has the highest mortality rate in both men and women. For treatment and prognosis of lung cancer most defining role has the clinical stage determined with the 8th edition of the TNM classification. To determine the treatment strategy, in particular the choice between operative treatment, preoperative systemic therapy or palliative therapy, one of the defining factors is the N-stage, which is determined by the presence of mediastinal dissemination from the primary tumor process. This stage can be defined mainly by performing imag-ing methods such as CT, PET/CT and MRI but they do not give histological confirmation of a metastatic process and there is a risk of overdiagnosis of N2-3 or vice versa – deter-mination of a lower N-stage in the presence of micrometastases in some lymph nodes. In order to make the definition of the N-stage as precise as possible the method of obtaining samples from the lymph nodes in the mediastinum via mediastinoscopy is ap-plied. It is a method of surgical excision of certain nodes, biopsy of a certain suspicious node or total removal of nodes from a series of regions in the mediastinum – VAMLA. Different groups of patients were studied, and the recovery period, early perioperative complications and the diagnostic value of the method were examined.

Key words: lung cancer, mediastinoscopy, mediastinal lymphadenopathy

Address for correspondence: Ivoslav Ivanov, МD, e-mail: ivoslavivanov@gmail.com