Radical lung cancer surgery, how to remove mediastinal tumor?

Lung cancer has cough, bloody sputum, chest pain and weight loss as the main symptoms. Traditional treatment method adopts conventional radical lung cancer resection. The special treatment of our department adopts radical resection of lung cancer with intraoperative radioactive particle placement and intraoperative chemotherapy pump placed in the pulmonary artery. This treatment can effectively kill the residual tumor cells and improve the survival rate of the patients, as intraoperative radiation particle placement and intraoperative chemotherapy pump in the pulmonary artery can effectively kill the residual tumor cells. Radical lung cancer surgery is currently recognized worldwide as the treatment of choice for non-small cell lung cancer. The goal of surgery is to completely remove the primary tumor lesion from the lung, remove the hilar and mediastinal lymph nodes, and preserve as much healthy lung tissue as possible. The most common surgical procedure is lobectomy or total pneumonectomy with hilar and mediastinal lymph node dissection, called radical lung cancer surgery. Among them, total pneumonectomy will cause incapacity, high complications and high mortality, and should be avoided as much as possible. Recently developed new procedures, such as bronchial sleeve lobectomy and bronchial and pulmonary artery double sleeve lobectomy, as well as autologous lobe reimplantation, which is still in its infancy, can reduce part of total pneumonectomy, expand the indications for surgery for patients of advanced age and poor cardiopulmonary function, and better preserve healthy lung tissue, which is called lung-preserving radical lung cancer surgery. Extra-thoracic (supraclavicular, axillary) lymph node metastasis or contralateral mediastinal lymph node metastasis or distant organ (adrenal gland, bone, brain, liver, contralateral lung, etc.) metastasis, or poor general condition are contraindications to surgical therapy. For microscopic lung cancer less than 1 cm in diameter, the 5-year survival rate can be more than 75% after surgical resection. 5-year survival rate for stage I lung cancer is 50%-60%, 19%-34% for stage IIa, 23%-25% for stages IIb and IIIa, 6%-20% for stage IIIb, and 1%-5% for stage IV. The 5-year survival rate was 42% after radical resection and 17% after palliative resection. Mediastinal tumors There are more tissues and organs in the mediastinum, and the origin of fetal structures is complicated, so there are many kinds of tumors in the mediastinum. There are primary and metastatic tumors. Among primary tumors, benign tumors are common, but there are also a considerable number of malignant ones. Mediastinal tumors can cause the following symptoms: (1) Respiratory symptoms: chest tightness and chest pain usually occur behind the sternum or on the diseased side of the chest. Most of the malignant tumors invade the bone or nerve, then the pain is severe. Cough is often caused by pressure on trachea or lung tissue, and hemoptysis is less common. (2) Neurological symptoms: Various symptoms are produced by tumor compression or nerve erosion: for example, tumor invasion may cause hoarseness, chest pain or abnormal sensation, and limb paralysis. (3) Infection symptoms: If the cyst breaks down or the tumor infection affects the bronchus or lung tissue, a series of infection symptoms will appear. (4) Compression symptoms: If the esophagus and trachea are compressed, symptoms such as shortness of breath or hypopharyngeal obstruction may appear. (5) Special symptoms: Patients cough up sebaceous material and hair. Except for malignant tumors of lymphatic origin for which radiotherapy is indicated, most primary mediastinal tumors should be treated surgically as long as there are no other contraindications. Even if benign tumors or cysts are asymptomatic, surgery is advisable because they will gradually grow and compress adjacent organs, or even develop malignancy or secondary infection. If malignant mediastinal tumor has invaded adjacent organs and cannot be removed or has distant metastasis, surgery is contraindicated and radiotherapy or chemotherapy can be given according to the pathological nature.