Finding the Limit between Station 2 and Station 4 during Right-Sided Thoracotomy

Introduction

Mediastinal lymph node dissection is a key part of resection for lung cancer to obtain a radical resection and accurate staging. On the right side, the upper limit of the paratracheal region is represented by lymph node station 2, which is separated from station 4 by a line drawn tangentially to the upper margin of the aortic arch [[1]]. This line is not visible during mediastinal dissection. Therefore, during right thoracotomy, the definition of station 2 is arbitrary. As the involvement of the nodal station 2 has been considered to be a marker for incomplete resection in many lung cancer trials [[2]], the precise definition of the lower limit of this station is important.

Recently, we developed an intraoperative technique to assess this limit properly during mediastinoscopy [[3]]. We modified this simple technique for use during mediastinal dissection through a right thoracotomy.

References

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