经颈纵隔镜行对侧纵隔淋巴结切除术在非小细胞肺癌治疗中的临床应用探索【摘要】目的提出经颈纵隔镜淋巴结清扫术（transcervicalvideo-assistedmediastinoscopiclymphadenectomy，VAMLA）行对侧纵隔淋巴结切除这一手术方法在非小细胞肺癌（NSCLC）手术中的应用，并探讨其在NSCLC中的应用指征及价值。方法在2015年1月至2016年3月共实施了25例VAMLA联合非小细胞肺癌根治手术，其对相关临床资料及术后病理结果资料进行分析。结果所有病例均顺利完成手术，无手术死亡病例。2例出现CT下对侧纵隔淋巴结阴性但纵隔镜切除后检查发生纵隔淋巴结转移，2例均为腺癌。23例对侧纵隔淋巴结均为病理阴性，进一步行肺癌根治手术。其中PET-CT考虑对侧纵隔淋巴结转移，但纵隔镜切除后实际纵膈淋巴结无转移3例。鳞癌15例，腺癌8例，左侧肺癌19例，右侧肺癌4例。结论VAMLA行对侧纵隔淋巴结切除术在非小细胞肺癌的应用，不仅仅使肺癌的分期更加准确，全面，对于下一步的治疗决策的制定、预后评估具有重要意义；也有利于术后的复查及评估。【关键词】非小细胞肺癌；经颈纵隔镜淋巴结清扫术；VAMLA；纵隔镜；纵隔淋巴结ClinicalApplicationofContralateralMediastinalLymphNodeDissectionthroughMediastinoscopyonNon-smallCellLungCancerLIXu，WANGWen-xiang，YANGDe-song，TANGJin-ming，ZHANGBai-hua，WUJie，HunanCancerHospitalandTheAffiliatedCancerHospitalofXiangyaSchool，theofMedicineSecondDepartmentofThoracicSurgery，CentralSouthUniversity，Changsha，Hunan，China，410013Correspondingauthor：LIXu，Email：lixu@hnszlyy.com[Abstract]ObjectiveThemethodoftranscervicalvideo-assistedmediastinoscopiclymphadenectomy（VAMLA）practisescontralateralmediastinallymphnodedissectioninonnon-smallcelllungcancer（NSCLC）andtodiscussitsindicationsandvalue.MethodsTwenty-fivepatientshadbeenundergoneVAMLAcombinedwithnon-smallcelllungcancerunderwentradicalsurgeryfromJanuary2015toMarch2016.Theclinicaldataandpathologicalresultswereanalyzed.ResultsAllthecasesweresuccessfullycompletedwithoutoperativedeath.2casesofCTconsideredcontralateralmediastinallymphnodemetastasis，buttheactualmediastinallymphnodethroughmediastinoscopiclymphadenectomyisnegativein，both2casesofadenocarcinoma.23casesofcontralateralmediastinallymphnodeswerepathologically，furthernegativeradicalsurgeryforlungcancer.PET-CTconsideredcontralateralmediastinallymph，nodebutmetastasistheactualmediastinallymphnodethroughmediastinoscopiclymphadenectomyisnegativein3cases.Squamouscellcarcinomain15，cases8casesofadenocarcinoma，19casesofleftlungcancer，rightlungcancerin4cases.Conclusions，notVAMLAonlytomakelungcancerstagingmoreaccurate，com