Uniportal VATS Node Excision-Post Immunotherapy Peribronchial Nodal Recurrence-Post Lobectomy status скачать в хорошем качестве

Uniportal VATS Node Excision-Post Immunotherapy Peribronchial Nodal Recurrence-Post Lobectomy status

This surgical video demonstrates a uniportal video-assisted thoracoscopic surgery (uVATS) node excision in a 55-year-old male with a history of carcinoma lung (left lower lobe). The patient underwent VATS left lower lobectomy (HPE: MD-SCC, pT2N0), followed by adjuvant chemotherapy and immunotherapy (Nivolumab). Surveillance PET-CT, 1 year later showed a metabolically active left peribronchial lymph node (1.5 × 1 cm) with no evidence of distant metastasis. Diagnosis: Isolated nodal recurrence. HPR of node -Metastatic SCC Oncological Significance: Isolated nodal recurrence after initial resection is a potentially curable scenario. Surgical excision provides both diagnostic confirmation and therapeutic benefit, particularly in oligorecurrent disease. In well-selected patients, surgery may complement systemic therapy and extend disease-free survival. Challenges: Prior lobectomy often leads to adhesions, distorted anatomy, and is technically challenging. Impact of Prior Immunotherapy: Immunotherapy (e.g., Nivolumab) can induce fibrotic or inflammatory changes around nodes and bronchovascular structures, making dissection more demanding. ✨️Minimally Invasive Advantage: Compared to redo thoracotomy, uVATS significantly reduces postoperative pain, hospital stay, and morbidity — crucial for patients who may require further treatment. This case highlights the evolving role of minimally invasive thoracic surgery in complex reoperative and immunotherapy-altered fields. #thoracicsurgery #cancersurgeon #lungcancer #lobectomy #immunotherapy #oncologist #uVATS #uniportalvats #cancer #surgical #surgicalvideos