Abstract
We performed a thoracoscopic surgery for right lung cancer under a mini-thoracotomy and mediastinal lymphnode dissection using video-assisted mediastinoscopy through thoracotomy (reverse mediastinoscopy). A 67-years-old male was admitted with an abnormal shadow of right lower lobe on chest X-ray. Pathologic diagnosis of the bronchoscopic biopsy specimens was an adenocarcinoma. The patient underwent video-assisted right low lobectomy and mediastinal lymphnodes dissection using reverse mediastinoscopy. We inserted mediastinoscope into the subcarinal space displacing the lung, the left atrium and the esophagus, and dissected the subcarinal nodes completely. We also inserted the mediastinoscope into upper mediastinum and dissected upper mediastinal, pre-tracheal and tracheo-bronchial nodes. The subcarinal and pre-tracheal nodes were completely dissected and others were not, which we dissected through mini-thoracotomy. We concluded that reverse mediastinoscopy might be useful for dissecting the pre-tracheal and subcarinal nodes under a video-assisted thoracoscopy.
