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The journal «ONCOSURGERY» 2013, Vol.5, No 2

Video-assisted mediastinal lymphadenectomy for advanced thyroid cancer

Reshetov IV, Golubtsov АК, Sevrjukov FЕ, Kazakevich VI, Krekhno OP

PA Herzen Moscow Cancer Research Institute, Moscow, Russia
Contact: Sevryukov Felix Eugenievich, e-mail:

Surgical treatment in patients with thyroid cancer and mediastinal lymphadenopathy is reviewed in the article.

Material and methods. The experience of treatment of 117 patients with thyroid cancer, who underwent video-assisted removal of lymph nodes and fat tissue of anterior superior mediastinum using proprietary technique developed in the department of microsurgery in P.A. Herzen Moscow Cancer Research Institute from 2000 to 2010. The age of patients varied from 16 to 79 y.o., the mean age accounted for 45.

Results. For routine morphological study 91 (78%) patients had thyroid cancer metastasis: papillary – in 73, follicular − in 3, medullary − in 14, undifferentiated − in 1 patient. 26 (22%) patients had no metastasis of thyroid cancer. The number of dissected lymph nodes were on average 8.9 (maximum − 37). The duration of surgery was half as much comparing with sternotomy. For 5-year follow-up 4 of 91 patients had tumor progression, 1 patient had recurrence of thyroid cancer metastasis, 87 patients had no metastasis in mediastinum according to results of full examination. There were no complications associated with this surgery.

Conclusion. Video-assisted lymph node dissection in anterior superior mediastinum for thyroid cancer metastasis is shown to be adequate and curative. This type of surgery decreases surgical injury comparing with sternotomy and allows for superior esthetic result. The application of proposed technique allows removal of lymph nodes and fat in superior anterior mediastinum using minimally invasive approach with video-assisted endoscopic devices according to oncological principles of radicality.

KEY WORDS: thyroid gland; cancer; metastasis; lymphadenopathy; mediastinum; video-assistance.

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