Effect of thoracoscopic right upper mediastinal dissection for left lung cancer-Especially about micrometastasis to lymph nodes-

胸腔镜右上纵隔切除术治疗左肺癌的效果-特别是淋巴结微转移-

• 批准号: 21591819
• 负责人: KAWAHARA Katsunobu
• 金额: $ 1.83万
• 依托单位: Oita University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2009
• 资助国家: 日本
• 起止时间: 2009 至 2011
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-21591819/
• 关键词: 肺癌; 胸腔鏡下両側縦隔リンパ節郭清; 微小リンパ節転移; skip metastasis; 両側縦隔リンパ節郭清; 胸腔鏡手術; 微小転移; 左肺癌; RT-PCR; 両側縦隔郭清

Background : Survival of patients with stage I non-small cell left lung cancer is not sufficient, probably, because of high incidence of the contralateral mediastinal node involvement. In this study, we investigated retrospectively occult micrometastases to the right upper mediastinal nodes in patients with stage I left lung cancer using a real-time quantitative reverse transcription-polymerase chain reaction(RT-PCR) method. Material and methods : 21 patients with clinical stage I non-small-cell left lung cancer underwent VATS lobectomy and bilateral mediastinal lymph node dissection(BMD). Clinical data and survival of patients with BMD were compared with those of 27 left-unilateral mediastinal node dissection(UMD). Occult micrometastases were detected using cytokeratin 19 mRNA RT-PCR method. Results : The operative time, blood loss, duration of chest tube drainage, and duration of postoperative hospital stay were not different between BMD and UMD patients. Pathological N2 disease was one patients. 20 patients had pN0 disease. Nodal micrometastases of right mediastinum were detected in 9/21(42. 8%) patients. Skip micrometastases to the level N3 nodes without the N1and N2 node involvement was observed in 7/9(77. 8%) patients. Patients with BMD are all alive and have no recurrence during median follow-up period of 13. 9 months. Overall 3-year survival and disease free 3-year survival of BMD patients were not significant difference from those of UMD patients. Conclusion : Thoracoscopic right upper mediastinal dissection for left lung cancer is safe and feasible. In our preliminary study, occult micrometastases to the level N3 nodes occurred frequently in patients with clinical N0 stage I non-small cell left lung cancer. Possibly, postoperative survival of patients with occult micrometastases to the level N3 node is not poor. Further follow up and work are needed.

背景：I期非小细胞左肺癌患者的生存率不高，可能是因为对侧纵隔淋巴结受累的发生率较高。在本研究中，我们采用实时定量逆转录聚合酶链反应（RT-PCR）方法回顾性研究了 I 期左肺癌患者右上纵隔淋巴结的隐匿性微转移。材料与方法：21例临床I期非小细胞左肺癌患者接受VATS肺叶切除术和双侧纵隔淋巴结清扫术（BMD）。将BMD患者的临床资料和生存情况与27例左单侧纵隔淋巴结清扫术（UMD）患者的临床资料和生存情况进行比较。采用细胞角蛋白19 mRNA RT-PCR 方法检测隐匿性微转移。结果：BMD 和 UMD 患者的手术时间、失血量、胸管引流时间和术后住院时间没有差异。病理为N2病患者1例。 20 名患者患有 pN0 疾病。 9/21(42. 8%)患者检出右纵隔淋巴结微转移。 7/9（77. 8%）的患者观察到跳至 N3 淋巴结的微转移，但没有 N1 和 N2 淋巴结受累。 BMD 患者均存活，中位随访时间为 13. 9 个月，未出现复发。 BMD患者的总体3年生存率和无病3年生存率与UMD患者没有显着差异。结论：胸腔镜下右上纵隔切除术治疗左肺癌安全、可行。在我们的初步研究中，N3淋巴结水平的隐匿性微转移经常发生在临床N0 I期非小细胞左肺癌患者中。可能，隐匿性微转移至 N3 淋巴结的患者术后生存率并不差。还需要进一步的跟进和工作。

项目成果

気管壊死に対する外科的治療

气管坏死的手术治疗

• 发表时间: 2011
• 期刊: 小児外科
• 作者: Yamashita S;Yamashita S;中城正夫;宮脇美千代
• 通讯作者: 宮脇美千代

Usefulness of right upper mediastinal dissection for left lung cancer

右上纵隔切除术对左肺癌的有用性

• 发表时间: 2011
• 作者: K Anami;T Moroga;K Tokuishi;M Kamei;S Suehiro;M Miyawaki;S Takeno;M Chujo;S Yamamoto;S Yamashita;K Kawahara
• 通讯作者: K Kawahara

Survivin expression in oesophageal squamous cell carcinoma: its prognostic impact and splice variant expression

• DOI: 10.1016/j.ejcts.2009.05.056
• 发表时间: 2010-02-01
• 期刊: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
• 影响因子: 3.4
• 作者: Takeno, Shinsuke;Yamashita, Shin-ichi;Kawahara, Katsunobu
• 通讯作者: Kawahara, Katsunobu

特発性食道破裂による急性膿胸に対する胸腔鏡手術

胸腔镜手术治疗特发性食管破裂急性脓胸

• 发表时间: 2010
• 期刊: 胸部外科
• 作者: Ito K;Yano T;Morodomi Y;Yoshida T;Kohno M;Shikada Y;Okamoto T;Maruyama R;Maehara Y;山下眞一
• 通讯作者: 山下眞一

左肺癌に対する両側胸腔鏡下縦隔郭清の手技

双侧胸腔镜纵隔解剖技术治疗左肺癌

• 发表时间: 2010
• 作者: 矢野篤次郎;他;阿南健太郎;宮脇美千代
• 通讯作者: 宮脇美千代