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Related Concept Videos

Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

Endoscopic Studies I: Bronchoscopy and Thoracoscopy

Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due to...

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Updated: Jun 2, 2026

Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
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Lymph Node Dissection and Postoperative Complications After Lung Cancer Resection.

Isheeta Madeka1, Khaled Noueihed1, Jacob Woodroof1

  • 1Department of Surgery, Division of Esophageal and Thoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

JAMA Network Open
|June 1, 2026
PubMed
Summary
This summary is machine-generated.

The 3+1 lymph node sampling rule for lung cancer does not increase postoperative complications. This guideline-concordant care strategy is safe for patients undergoing non-small cell lung cancer resection.

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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer

Published on: February 27, 2026

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Current lung cancer guidelines recommend the 3+1 rule for lymph node sampling (LNS), involving at least 3 mediastinal (N2) and 1 hilar (N1) nodal stations.
  • While rigorous LNS offers oncologic benefits, its impact on surgical outcomes requires thorough investigation as its adoption increases.

Purpose of the Study:

  • To determine if adherence to the 3+1 lymph node sampling rule is associated with a higher rate of postoperative complications in non-small cell lung cancer (NSCLC) patients.

Main Methods:

  • A retrospective cohort study analyzed data from the Society of Thoracic Surgeons General Thoracic Database (July 2021-January 2023).
  • Patients with clinical stage T1-T3, N0, M0 NSCLC undergoing resection with known LNS were included.
  • Propensity matching was used to compare postoperative complication rates between patients who did and did not satisfy the 3+1 rule.

Main Results:

  • The study included 28,439 NSCLC patients; 66.6% met the 3+1 rule criteria.
  • Unadjusted analysis showed longer operating times and higher rates of pathologic upstaging in the 3+1 group.
  • Post-propensity matching analysis revealed no significant differences in postoperative complication rates between the groups.

Conclusions:

  • Adherence to the 3+1 lymph node sampling rule in NSCLC surgery is not associated with increased postoperative complications.
  • These findings support the safety of the 3+1 rule, encouraging its continued use as guideline-concordant care.