Lymph node dissection - understanding the immunological function of lymph nodes

Objective This study investigated the use of a new bipolar sealing device (BSD) in right superior mediastinal lymph node dissection during thoracoscopic surgery. Methods The study population consisted of 42 consecutive patients undergoing lobectomy with right superior mediastinal lymph node dissection for primary lung cancer. Operative results were compared with those of conventional surgery in 42 background-matched controls. The primary endpoint for the present analysis was the success of right superior mediastinal lymph node dissection during thoracoscopic surgery using a BSD. The secondary endpoints included the duration of the operation, number of dissected lymph nodes, chest drainage volume and duration, postoperative hospital stay, morbidity, and mortality. Results The BSD was used successfully in 42 patients. No significant difference in duration of lymph node dissection, chest drainage volume, drainage duration, or number of dissected lymph nodes was observed between the study group and the controls. Because of a learning curve, the procedure initially took more than 20 minutes to complete, but surgical time was reduced to approximately 15 minutes after the procedure was performed in 15 patients. Conclusions Our method is safe and in no way inferior to the conventional procedure. The tendency of the learning curve suggests that a significantly shorter duration of lymph node dissection is possible using this method.

Download Full-text

Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2003.11.006 ◽

2004 ◽

Vol 22 (1) ◽

pp. 73-74

Author(s):

A.J Pantuck ◽

A Zisman ◽

F Dorey ◽

D.H Chao ◽

K.R Han ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Lymph Node ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Lymph Node Dissection ◽

Renal Cell ◽

Node Dissection

Download Full-text

D3 LYMPHADENECTOMY IN RIGHT COLONIC RESECTION

JMS SKIMS ◽

10.33883/jms.v21i2.345 ◽

2019 ◽

Vol 21 (2) ◽

pp. 109-113

Author(s):

Arshad Ahmed Baba ◽

Zahid Kaleem ◽

Fazl Qadir Parray ◽

Nisar Ahmad Chowdri ◽

Rouf Ahmad Wani ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Node Dissection ◽

D3 Lymphadenectomy ◽

Quality Of Surgery ◽

Staining Techniques ◽

Node Metastases ◽

The Individual

Lymph node dissection in colon cancer is without a doubt necessary, it is just the extent of that dissection that is still under debate. As the individual steps of an oncologic operation cannot be separated from each other, analysis of the significance of lymph node dissection alone is difficult. It has been proven that the T category is directly related to the number and central spread of lymph node metastases. Micrometastases and isolated tumor cells may be detected in lymph nodes by using special staining techniques; their presence may worsen prognosis significantly and approximate it to UICC stage III. The numbers of dissected lymph nodes and the ratio of involved versus dissected lymph nodes have been used as markers for quality of surgery and histopathological evaluation. JMS 2018: 21 (2):109-113

Download Full-text

Lymph Nodes Involvement and Lymphadenectomy in Thymic Tumors: Tentative Answers for Unsolved Questions

Cancers ◽

10.3390/cancers13205085 ◽

2021 ◽

Vol 13 (20) ◽

pp. 5085

Author(s):

Debora Brascia ◽

Angela De De Palma ◽

Marcella Schiavone ◽

Giulia De De Iaco ◽

Francesca Signore ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Lymph Node Metastases ◽

Lymph Node Involvement ◽

Postoperative Management ◽

Anterior Mediastinum ◽

Node Dissection ◽

Node Metastases ◽

Thymic Tumors

Thymic tumors are the most common primary neoplasms of the anterior mediastinum, although, when compared with the entire thoracic malignancies, they are still rare. Few studies addressed the questions about lymph node involvement pattern in thymic neoplasms, about which subgroup of patients would be appropriate candidates for lymph node dissection or about the extent of lymphadenectomy or which lymph nodes should be harvested. The aim of this review is to collect evidence from the literature to help physicians in designing the best surgical procedure when dealing with thymic malignancies. A literature review was performed through PubMed and Scopus in May 2021 to identify any study published in the last 20 years evaluating the frequency and the extent of lymph node dissection for thymic tumors, its impact on prognosis and on postoperative management. Fifteen studies met the inclusion criteria and were included in this review, with a total of 9452 patients with thymic cancers; lymph node metastases were found in 976 (10.3%) patients in total. The current literature is heterogeneous in the classification and reporting of lymph node metastases in thymic carcinoma, and data are hardly comparable. Surgical treatment should be guided by the few literature-based pieces of evidence and by the experience of the physicians.

Download Full-text

Outcome of Cervical Lymph Nodes Dissection for Thyroid Cancer with Nodal Metastases: A Southeast Asian 3-Year Experience

International Journal of Surgical Oncology ◽

10.1155/2019/6109643 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Raymond Z. M. Lim ◽

Juin Y. Ooi ◽

Jih H. Tan ◽

Henry C. L. Tan ◽

Seniyah M. Sikin

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Neck Dissection ◽

Lymph Node Dissection ◽

Endocrine Surgery ◽

Node Dissection ◽

Referral Centre ◽

Local Data ◽

Cervical Lymph Nodes

Introduction. Therapeutic nodal dissection is still the mainstay of treatment for patients with lymph node metastases in many centres. The local data, however, on the outcome of therapeutic LND remains limited. Hence, this study aims to inform practice by presenting the outcomes of LND for thyroid cancer patients and our experience in a tertiary referral centre.Methods. This is a single-centre retrospective observational study in a Malaysian tertiary endocrine surgery referral centre. Patients who underwent total thyroidectomy with lymph node dissection between years 2013 and 2015 were included and electronic medical records over a 3-year follow-up period were reviewed. The outcomes of different lymph node dissection (LND), including central neck dissection, lateral neck dissection, or both, were compared.Results. Of the 43 subjects included, 28 (65.1%) had Stage IV cancer. Among the 43 subjects included, 8 underwent central LND, and 15 had lateral LND while the remaining 20 had dissection of both lateral and central lymph nodes. Locoregional recurrence was found in 16 (37.2%) of our subjects included, with no statistical difference between the central (2/8), lateral (7/15), and both (7/20). Postoperative hypocalcaemia occurred in 7 (16.3%) patients, and vocal cord palsy occurred in 5 (11.6%), whereas 9 patients (20.9%) required reoperation. Death occurred in 4 of our patients.Conclusion. High recurrence and reoperative rates were observed in our centre. While the routine prophylactic LND remains controversial, high risk patients may be considered for prophylactic LND. The long-term risk and benefit of prophylactic LND with individualised patient selection in the local setting deserve further studies.

Download Full-text