[Mediastinal lymphadenectomy in bronchus carcinoma--techniques and problems]

Mediastinal lymph node dissection in bronchial carcinoma patients means an additional procedure to the tumor resection. The en-bloc dissection is only possible if an upper lobe resection or a pneumonectomy is performed; otherwise, an isolated lymph node mapping is necessary. According to the different anatomical structures, mediastinal lymph node dissection is more easily performed on the right than on the left side, where mobilisation of the aortic arch or a longitudinal sternotomy is mandatory to sample the pre- and paratracheal lymph nodes. Up to now it is uncertain whether lymph node dissection improves the prognosis. But undoubtedly it is the basis for an exact staging.