What are the possible complications of mediastinal lymphadenectomy?

Updated: Feb 16, 2021
  • Author: R James Koness, MD, FACS; Chief Editor: Erik D Schraga, MD  more...
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Answer

Either systematic lymph node sampling or complete mediastinal lymph node dissection may be associated with complications related to the possible interruption of blood supply to the bronchial stump, removal of a large amount of intrathoracic lymphatics, and possible nerve injury.

However, mediastinal lymph node dissection itself is not associated with any loss of pulmonary function. Izbicki reported the most complete data on morbidity in the first publication from the German group. [9]  This randomized trial compared mediastinal lymph node sampling with mediastinal lymph node dissection in 182 patients. The complete lymph node dissection required 22 minutes longer to perform but was associated with no increase in mortality, intraoperative blood loss, or need for repeat thoracotomy.

Postoperatively, no difference was noted in the number of patients with complications or any specific complication except a nonsignificant trend in chest tube air leaks (>5 days) and number of patients receiving more than 2 units in the 30-day postoperative time period. [9] Length of intensive care unit (ICU) and hospital stay was not dissimilar. In summary, mediastinal lymph node dissection has no impact on operative morbidity, mortality, and quality of life, and such concerns should have no impact on the decision to include this procedure in the surgical lung resection.


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