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How to deal with benign hilar or interlobar lymphadenopathy during video-assisted thoracoscopic surgery lobectomy
Shi Yan1, Chao Lv1, Xing Wang1
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing 100142, China.
Background:
Video-assisted thoracoscopic surgery (VATS) surgery has changed the way lobectomy procedure was performed over the past few decades. However, some difficulties impede the accomplishment of VATS lobectomy, which of them, benign lymphadenopathy may pose a threat to safety of surgery.
Methods:
We reported a case with enlarged hilar and interlobar lymph nodes. The video showed the instrumentation and techniques that we had adopted to deal with the complicated dilemma during the operation. Critical experience was also suggested in some hypothetical scenarios.
Results:
AS techniques were further refined, successful VATS segmentectomy or lobectomy with challenging hilar or interlobar lymphadenopathy could be performed without uncontrolled bleeding or unexpected conversion.
Conclusions:
A VATS approach is acceptable in the management of benign hilar or interlobar lymphadenopathy. However, facile technique is necessary to deal with intraoperative dilemma. To those who are not sure about the practicability of the VATS procedure, planned conversion is still an effective method to ensure safety of the operation.