Thoracoscopic lymphadenectomy via uniportal approach

Date
2021-11-30
Authors
Al-Qtishat, Bayan Fathi
Idais, Shahd Tahseen
Abu Akar, Firas
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Abstract
Performing a radical lymphadenectomy is an obligation for a complete resection in non-small cell lung cancer. Mediastinal lymphadenectomy is indicated whenever a diagnosis of lymphadenopathy is not possible via imaging techniques. With the uprising use of uniportal video-assisted thoracoscopy and the accumulating literature of its safety and efficacy compared to multiportal approach, thoracoscopic lymphadenectomy via uniportal approach is a common terminology to come across. The use of uniportal video-assisted thoracoscopy lymphadenectomy offers a lower complication rate, postoperative paresthesia, and pain when compared to the multiportal approach. With a reported higher tolerability, efficiency, safety, and better cosmetic outcome; it is more appealing to the patients. Though it is becoming easier to perform with experience, it is still a complicated procedure with many challenges. These challenges can be related to implementing the technique itself, or due to its linkage to the development of the instruments industry and the overall high cost of the procedure. In this review, we walk you through the history of the approach from the idea to todays’ form of video-assisted thoracoscopy, mediastinal lymphadenectomy via uniportal video-assisted thoracoscopy indications, contraindications, and outcomes; an extensive explanation of the lymph node dissection technique with specific considerations for each lymph node station. The article is supplemented with an anatomical overview of the mediastinal lymph nodes; supported by videos of the technique for a better visual review and learning experience, ending with extra challenges faced in implementing the technique in developing countries.
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Keywords
Lymphadenectomy, lymph node dissection, uniportal VATS, uniportal VATS technique, single port
Citation
Cite this article as: Al-Qtishat BF, Idais ST, Abu Akar F. Thoracoscopic lymphadenectomy via uniportal approach. AME Surg J 2021.