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Title: Clinical aspects of bilateral mediastinal lymphadenectomy in surgically treated patients with non-small cell lung cancer

Abstract:

Bilateral lymphadenectomy (BML) is not considered the standard surgical treatment for the non-small celi lung cancer (NSCLC). However, an anatomical study of lymph flow from different segments of the lung showed that lymph flow to contralateral mediastinal lymph nodes is common, especially from the left lower lobe. Metastatic deposits left in the lymph nodes on the other side of the mediastinum, which are not removed during standard surgery, may lead to cancer recurrence. This finding has prompted attempts to extend lymph node dissection to the contralateral mediastinum, and promising results have been published by several nonrandomized studies. However, this techniąue has never gained wide acceptance because of its invasiveness and lack of large, randomized studies confirming its efficiency. Beside its potential survival benefit, BML provides an opportunity for comprehensive study of surgical anatomy of mediastinal lymphatics and functional effects of extensive removal of the mediastinal content. The prevalence and number of detectable nodes at particular stations of the mediastinum are important to clinicians dealing with lung cancer. Unfortunately, the number of lymph nodes in patients with NSCLC has not been specifically studied, and relevant data are scarce. Most studies of the anatomy of mediastina 1 lymphatics have been based on investigations of groups without lung path ; ology and analysed radiological or autopsy findings ratherthan surgical specimens. Also, little is known about the effect of BML on pulmonary function in the postoperative period. Theoretically, bilateral removal of mediastinal lymphatics may result in lung parenchymal oedema, with subsequent impairment of ventilatory function. As BML includes morę extensive dissection of mediastinal structures than systematic lymph node dissection (SLND), there is a concern regarding the risk of complications. These issues were not studied so far.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

torakochirurgia ; onkologia ; pulmonologia

Degree grantor:

Rada Dyscypliny Nauki medyczne

Promoter:

Kużdżał, Jarosław ; Nęcki, Mirosław

Date issued:

2025

Identifier:

oai:dl.cm-uj.krakow.pl:6103

Call number:

ZB-143676

Language:

pol; eng

Access rights:

tylko w bibliotece

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Last modified:

Feb 18, 2026

In our library since:

Feb 18, 2026

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http://dl.bm.cm-uj.krakow.pl:8080/publication/6104

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ZB-143676 Feb 18, 2026
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