Patient Education Handbook As Soon As I Was Diagnosed with Lung Cancer
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Mediastinoscopic Esophagectomy with Lymph Node Dissection Using a Bilateral Transcervical and Transhiatal Pneumomediastinal Approach
Tokairin et al. Mini-invasive Surg 2020;4:32 Mini-invasive Surgery DOI: 10.20517/2574-1225.2020.23 Technical Note Open Access Mediastinoscopic esophagectomy with lymph node dissection using a bilateral transcervical and transhiatal pneumomediastinal approach Yutaka Tokairin1,2, Yasuaki Nakajima2, Kenro Kawad2, Akihiro Hoshin2, Takuya Okada2, Toshihiro Matsui2, Kazuya Yamaguchi2, Kagami Nagai2, Yusuke Kinugasa2 1Department of Surgery, Toshima Hospital Tokyo Metropolitan Health and Hospitals Corporation, Tokyo 173-0015, Japan. 2Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo 113-8510, Japan. Correspondence to: Dr. Yutaka Tokairin, Department of Surgery, Toshima Hospital Tokyo Metropolitan Health and Hospitals Corporation, 33-1 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan. E-mail: [email protected] How to cite this article: Tokairin Y, Nakajima Y, Kawad K, Hoshin A, Okada T, Matsui T, Yamaguchi K, Nagai K, Kinugasa Y. Mediastinoscopic esophagectomy with lymph node dissection using a bilateral transcervical and transhiatal pneumomediastinal approach. Mini-invasive Surg 2020;4:32. http://dx.doi.org/10.20517/2574-1225.2020.23 Received: 17 Feb 2020 First Decision: 17 Mar 2020 Revised: 24 Mar 2020 Accepted: 1 Apr 2020 Published: 16 May 2020 Science Editor: Itasu Ninomiya Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang Abstract We developed a method for mediastinoscopic esophagectomy via a bilateral transcervical and transhiatal approach under pneumomediastinum as a less-invasive radical operation. The right recurrent nerve is first identified using an open approach, and the right cervical paraesophageal lymph nodes and part of the right recurrent nerve lymph nodes are dissected, after which pneumomediastinum is initiated. -
Table of Contents 1
GENERAL THORACIC SURGERY DATABASE v.2.3 TRAINING MANUAL January 2018 Table of Contents 1. Demographics ................................................................................................................................................................. 2 2. Follow Up ........................................................................................................................................................................ 9 3. Admission ..................................................................................................................................................................... 10 4. Pre-Operative Evaluation ............................................................................................................................................. 14 5. Diagnosis (Category of Disease) ................................................................................................................................... 49 6. Procedure ..................................................................................................................................................................... 72 7. Post-Operative Events ................................................................................................................................................ 114 8. Discharge .................................................................................................................................................................... 141 9. Quality Measures ...................................................................................................................................................... -
NCCN Guidelines for Patients: Non-Small Cell Lung Cancer
NCCN.org/patients/surveyPlease complete our online survey at NCCN Guidelines for Patients® Version 1.2016 Lung Cancer NON–SMALL CELL LUNG CANCER Presented with support from: Available online at NCCN.org/patients Ü NCCN Guidelines for Patients® Version 1.2016 Lung Cancer NON-SMALL CELL LUNG CANCER Learning that you have cancer can be overwhelming. The goal of this book is to help you get the best cancer treatment. It explains which cancer tests and treatments are recommended by experts of non-small cell lung cancer. The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of 27 of the world’s leading cancer centers. Experts from NCCN have written treatment guidelines for doctors who treat lung cancer. These treatment guidelines suggest what the best practice is for cancer care. The information in this patient book is based on the guidelines written for doctors. This book focuses on the treatment of non-small cell lung cancer. Key points of the book are summarized in the related NCCN Quick Guide™. NCCN also offers patient resources on lung cancer screening as well as other cancer types. Visit NCCN.org/patients for the full library of patient books, summaries, and other patient and caregiver resources. ® NCCN Guidelines for Patients i Lung Cancer – Non-Small Cell, Version 1.2016 Endorsers and sponsors Endorsed and sponsored in part by LUNG CANCER ALLIANCE LUNG CANCER RESEARCH COUNCIL Lung Cancer Alliance is proud to collaborate with National Comprehensive As an organization that seeks to increase public awareness and Cancer Network to sponsor and endorse these NCCN Guidelines for understanding about lung cancer and support programs for screening and Patients®: Non–Small Cell Lung Cancer. -
Collaborative Stage Manual Part II
SEER Program Coding and Staging Manual 2004, Revision 1 Collaborative Staging Codes Nasal Cavity C30.0 C30.0 Nasal cavity (excludes nose, NOS C76.0) Note: Laterality must be coded for this site, except subsites Nasal cartilage and Nasal septum, for which laterality is coded 0. CS Tumor Size CS Site-Specific Factor 1 - Size of The following tables are available CS Extension Lymph Nodes at the collaborative staging CS TS/Ext-Eval CS Site-Specific Factor 2 - website: CS Lymph Nodes Extracapsular Extension, Lymph Nodes Histology Exclusion Table CS Reg Nodes Eval for Head and Neck AJCC Stage Reg LN Pos CS Site-Specific Factor 3 - Levels I- Lymph Nodes Size Table Reg LN Exam III, Lymph Nodes for Head and Neck CS Mets at DX CS Site-Specific Factor 4 - Levels IV- CS Mets Eval V and Retropharyngeal Lymph Nodes for Head and Neck CS Site-Specific Factor 5 - Levels VI- VII and Facial Lymph Nodes for Head and Neck CS Site-Specific Factor 6 - Parapharyngeal, Parotid, Preauricular, and Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck Nasal Cavity CS Tumor Size SEE STANDARD TABLE Nasal Cavity CS Extension Code Description TNM SS77 SS2000 00 In situ; non-invasive Tis IS IS 10 Invasive tumor confined to site of origin T1 L L Meatus (superior, middle, inferior) Nasal chonchae (superior, middle, inferior) Septum Tympanic membrane 30 Localized, NOS T1 L L 40 Extending to adjacent connective tissue within the nasoethomoidal T2 RE RE complex Nasolacrimal duct 60 Adjacent organs/structures including: T3 RE RE Bone of skull Choana Frontal sinus Hard palate -
Alternative – Universal Extended Video Mediastinoscopy with Distending, Narrow Blades Extended Video Mediastinoscopy with Distending, Tapered Blade System
THOR 19 2.0 11/2020-E Alternative – Universal Extended video mediastinoscopy with distending, narrow blades Extended video mediastinoscopy with distending, tapered blade system By creating visibility and space, video mediastinoscopy allows the precise display and dissection of mediastinal structures and is therefore valuable for lymph node staging. Mediastinal staging as well as extended or complex endoscopic interventions, including video-assisted mediastinoscopic lymphadenectomy (VAMLA), can be performed with the aid of a distending video mediastinoscope system. KARL STORZ offers an atraumatic, easy-to-use, compact blade system with a holding arm device and an integrated irrigation and suction channel for this purpose. Two adjustment wheels in the handle allow distal distension of the blades and height adjustment in parallel. Combined with a matching HOPKINS® wide angle telescope, this autoclavable blade system provides the operating surgeon with an optimal overview of the working area. In conjunction with a holding arm with KSLOCK, bimanual work is also possible. The corresponding DCI® camera head IMAGE1 S™ D1 is operated via the modular KARL STORZ IMAGE1 S™ camera platform. Consequently, the system is likely to experience a renaissance in the coming years. We also offer instruments and other accessories that are compatible with the system. © KARL STORZ 96082019 THOR 19 2.0 11/2020 EW-E 2 Components of the KARL STORZ video mediastinoscopy system for extended mediastinoscopy Monitor 27" FULL HD Monitor TM220 Camera System IMAGE1 S CONNECT® -
Mediastinoscopy: a Clinical Evaluation of 400 Consecutive Cases
Thorax: first published as 10.1136/thx.24.5.585 on 1 September 1969. Downloaded from Thorax (1969), 24, 585. Mediastinoscopy: A clinical evaluation of 400 consecutive cases C. L. SARIN1 AND H. C. NOHL-OSER From the Thoracic Surgical Unit, Harefield Hospital, Harefield, Middlesex Mediastinoscopy was carried out in 400 cases, including 296 of bronchogenic carcinoma. At the time of presentation the new growth had already spread to involve the mediastinal lymph nodes in slightly more than 50% of these. The incidence of involvement was 76% in oat-cell and 35% in squamous-cell carcinoma. Non-resectability at thoracotomy was encountered in seven out of 120 patients. We advocate this procedure in every case of bronchogenic carcinoma which is considered operable on other counts. In patients in whom the mediastinal lymph nodes are invaded by growth we prefer radical radiotherapy to surgery, as the long-term survival of the two methods is comparable. This procedure may be the only source of positive histological proof of diagnosis, not only in carcinoma but in other types of intrathoracic disease. We believe that this procedure reduces the number of unnecessary exploratory thoracotomies. Carlens (1959) introduced diagnostic exploration sible. Biopsy in such cases can be obtained from tissues inside the thoracic inlet. in the of the superior mediastinum. The space explored just Bleeding, copyright. is part of the superior mediastinum which is presence of incipient or developed superior vena caval of the obstruction, or dense fibrosis of the pre-tracheal situated around tihe intrathoracic part fascia, can make the procedure difficult or impossible. -
Cervical Mediastinal L SUSAN ALEXANDER L for STAGING of LUNG CANCER
Cervical Mediastinal l SUSAN ALEXANDER l FOR STAGING OF LUNG CANCER ervical mediastinal exp- bronchogenic lung cancer by sam- loration (CME), or pling selected lymph nodes in and mediastinoscopy, is a around the trachea, its major surgical procedure to bifurcation and the great vessels. C explore and sample Lymph nodes are removed and lymph nodes in the space between sent to pathology for tissue diag- the lungs, (the mediastinum), nosis to determine the histology when diagnostic imaging studies of the tumor. CME is performed (X-ray, CT scan, etc) suggest a primarily to stage lung cancer growth in the lungs or mediasti- and determine the extent of the nal region. The most common pur- disease and establish treatment pose of the CME is to diagnose options. DECEMBER 2002 The Surgical Technologist 9 224 DECEMBER 2002 CATEGORY 1 If cancer exists in the lymph nodes, the cell type nodes that are not accessible through CME. In (histology) identifies the type of cancer and one series of 100 patients with tumors in this extent of the lymph nodes involved. If tumor area, 22 were found to be inoperable despite hav involvement in the mediastinal area is demon ing a negative mediastinoscopy.5 Left anterior strated in the pathology review of the speci- mediastinotomy through the second intercostal men(s) (lymph nodes), the patient may be space is the preferred method to assess the oper spared an unnecessary thoracotomy; however, ability of these patients, as suggested by Pearson this means that the tumor is inoperable.5 and coworkers.5 Less than 50% of patients undergoing cura History tive resection for bronchogenic carcinoma sur CME was originally described by Harken and vive five years. -
Experience with Video Mediastinoscopy at a Tertiary Cancer Center
Oncology and Radiotherapy © 1 (50) 2020: 001-005 • RESEARCH ARTICLE From radiological assumption to pathological conviction: experience with video mediastinoscopy at a tertiary cancer center Nizamudheen MP, Abhay K Kattepur, Satheesan B Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India Purpose: To describe the role of mediastinoscopy in the setting of mediastinaladenopathy secondary to pulmonary and non-pulmonary cancers. INTRODUCTION Methods: Retrospective analysis of patients undergoing video mediastinoscopy SUMMARY from November 2016 to December 2018 at tertiary cancer center for Cervical mediastinoscopy is a time tested tool for the mediastinaladenopathy from lung cancer and non-pulmonary cancers with invasive staging of mediastinal nodes. Standard cervical mediastinal nodes. mediastinoscopy helpsin approaching lymph node stations viz. Results: Twelve patients were included out of which 11 patients underwent right upper paratracheal (station 2R), right lower paratracheal diagnostic mediastinoscopy. The median age was 58 years. Seven patients had lung cancer. The mean number of nodes sampled was 10.5 (range: (4R), left upper paratracheal (2L), right lower paratracheal 2-28 nodes). Five patients had mediastinaladenopathy from non-pulmonary (4L) and sub-carinal (7). Hilar nodes (station 10) can also cancer like endometrial, oropharyngeal and Hodgkin’s lymphoma. Recurrent laryngeal nerve palsy was noted in one patient. be accessed byexperienced surgeons, although it can be Conclusion: Mediastinoscopy serves as a valuable asset for staging of lung technically challenging. Overall, this procedure is accurate and cancer and in the assessment of suspicious nodes in the setting of non- carries minimal morbidity [1]. The role of mediastinoscopy pulmonary cancers. However, training and expertise is in the need of the hour to prevent redundancy of this valuable procedure. -
Guidelines on the Diagnosis and Treatment of Primary Lung Cancer (2011)
G U I D E L I N E S Chinese guidelines on the diagnosis and treatment of primary lung cancer (2011) Xiu-yi Zhi1*, Yi-long Wu2*, Hong Bu3, Gang Cheng4, Ying Cheng5, Xiang Du6, Bao-hui Han7, Ge-ning Jiang8, Shun- chang Jiao9, De-ruo Liu10, Lun-xu Liu3, You Lu3, Sheng-lin Ma11, Yuan-kai Shi12, Chang-li Wang13, Jie Wang14, Tian- you Wang1, Yue Yang14, Qing-hua Zhou15, Lung Cancer Diagnosis and Treatment Expert Panel of the Chinese Ministry of Health 1Beijing Lung Cancer Center, Capital Medical University, Beijing; 2Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou; 3West China Medical School, West China Hospital, Sichuan University, Chengdu; 4Beijing Hospital, Beijing; 5Cancer Hospital of Jilin Province, Changchun; 6Cancer Hospital of Fudan University, Shanghai; 7Shanghai Chest Hospital, Jiaotong University, Shanghai; 8Shanghai Pulmonary Hospital, Tongji University, Shanghai; 9General Hospital of Chinese People's Liberation Army, Beijing; 10Beijing Sino-Japan Hospital, Beijing; 11Hangzhou Cancer Hospital, Hangzhou; 12Cancer Institute and Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing; 13Tianjin Cancer Hospital, Tianjin Medical University, Tianjin; 14Beijing Cancer Hospital, Peking University, Beijing; 15Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital J Thorac Dis 2012;4:88-101. DOI: 10.3978/j.issn.2072-1439.2010.08.01 Introduction . smoking with a smoking index of greater than 400 cigarettes/ year; a history of high-risk occupational exposure (eg. exposure Primary lung cancer (PLC) is one of the most common to asbestos) and family history of PLC; or at the age of 45 years malignant tumors in China. -
TNM Classification of Malignant Tumours
Table of Contents Cover Title Page Preface References Acknowledgments Organizations Associated with the TNM System Members of UICC Committees Associated with the TNM System Section Editors Introduction References Head and Neck Tumours Lip and Oral Cavity Pharynx References Larynx Nasal Cavity and Paranasal Sinuses Unknown Primary – Cervical Nodes Malignant Melanoma of Upper Aerodigestive Tract Major Salivary Glands Thyroid Gland Digestive System Tumours Oesophagus Stomach Reference Small Intestine Appendix Colon and Rectum Anal Canal and Perianal Skin Liver Intrahepatic Bile Ducts Gallbladder Perihilar Bile Ducts Distal Extrahepatic Bile Duct Ampulla of Vater Pancreas Well Differentiated Neuroendocrine Tumours of the Gastrointestinal Tract Lung, Pleural, and Thymic Tumours Lung References Pleural Mesothelioma Thymic Tumours References Tumours of Bone and Soft Tissues Bone Soft Tissues Gastrointestinal Stromal Tumour (GIST) Skin Tumours Carcinoma of Skin (excluding eyelid, head and neck, perianal, vulva, and penis) Skin Carcinoma of the Head and Neck Carcinoma of Skin of the Eyelid Malignant Melanoma of Skin Merkel Cell Carcinoma of Skin Breast Tumours Reference Gynaecological Tumours Reference Vulva Vagina Cervix Uteri Uterus – Endometrium Reference Uterine Sarcomas References Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma Reference Gestational Trophoblastic Neoplasms Reference Urological Tumours Penis Prostate References Testis Kidney Renal Pelvis and Ureter Urinary Bladder Urethra Adrenal Cortex (ICD O 3 C74.0) Ophthalmic -
Vascular Spread of Carcinoma of the Bronchus * by H
Thorax: first published as 10.1136/thx.11.3.172 on 1 September 1956. Downloaded from Thorax (1956), 11, 172. AN INVESTIGATION INTO THE LYMPHATIC AND VASCULAR SPREAD OF CARCINOMA OF THE BRONCHUS * BY H. C. NOHL From the London Chest Hospital (RECEIVED FOR PUBLICATION JANUARY 28, 1956) The present investigation was carried out be- Each spezimen while still fresh and unfixed was cause little work has been done to elucidate the carefully cleared of all the visible lymph nodes, and problems concerning the lymphatic spread of their relationship to the nearest bronchus was noted bronchogenic carcinoma. The question, whether and charted on a diagram (Fig. 1). the treatment of carcinoma of the bronchus by Vascular involvement was also looked for and lobectomy rather than by pneumonectomy is p.eces of pulmonary vein were sent for histological examination where invasion seemed most likely. based on sound pathological principles, needed Visceral or parietal pleural infiltration was noted and clarification. It was also felt that the establish- again microscopic confirmation was sought. And, ment of a surgical-pathological classification for lastly, the situation and extent of the growth were the purpose of prognosis and assessment of various carefully recorded. forms of treatment, as has been donz for cancer Each lymph node was then sectioned after fixation copyright. at other sites, was long overdue. Furthermore, and two slides were made of each gland. A serial the anatomy of the intrapulmonary lymphatic section of each lymph node was not done, as it would pathways described in the past are no longer have entailed an insurmountable amount of work. -
3D Printed Model of the Mediastinum for Cardiothoracic Surgery Resident Education Natalie S
3D printed model of the mediastinum for cardiothoracic surgery resident education Natalie S. Lui MD1, Winston Trope1, H. Henry Guo MD PhD2, Kyle Gifford2, Prasha Bhandari MPH1, Jalen Benson1, Douglas Z. Liou MD1, Leah M. Backhus MD MPH1, Mark F. Berry MD1, Joseph B. Shrager MD1 Divisions of 1Thoracic Surgery and 2Radiology, Stanford University School of Medicine, Stanford, CA Purpose Results Conclusion Mediastinoscopy remains the gold standard for mediastinal lymph node There were 51 resident self assessments and 65 attending assessments completed over A novel, 3D printed model of the mediastinum was an staging, but residents are performing fewer of them with the development of two years. (Residents and attendings could complete more than one assessment). effective tool for teaching cardiothoracic surgery endobronchial ultrasound. We hypothesized that a three-dimensional (3D) General surgery, integrated cardiac residents, and traditional thoracic and cardiac track residents the anatomy and techniques for printed model of the mediastinum would be an effective tool for teaching fellows were included. mediastinoscopy, as measured by resident self assessment and attending assessment. 3D printing is a residents the anatomy and techniques for mediastinoscopy. Residents taught with the 3D model (n=22) were more likely to respond “well” or “very promising technology with many potential applications Methods well” for three of the four self assessment questions. Attendings were more likely to in cardiothoracic surgery resident education. Computed tomography images were segmented using Materialise Mimics respond “very well” to two of the assessment questions. (Figure 4) (Materialise, Leuven, Belgium), and a color model of the mediastinum was Figure 4. Resident self assessments (A) and attending assessments (B) comparing 3D printed using a Stratasys J735 (Stratasys, Eden Prairie, MN).