Operative technique of a new surgical method, transcervical extended mediastinal lymphadenectomy (TEMLA), is described in detail. TEMLA enables almost complete en bloc removal of the mediastinal nodes in semiopen fashion. Sensitivity and negative predictive value of TEMLA for staging were 95.6% and 98.4%, respectively, and for restaging, 95.7% and 98.4%, respectively. Other uses of TEMLA include resection of the mediastinal tumors and resection of the metastatic nodes to the mediastinum, esophagectomy with 3-field dissection (combined with laparoscopy or laparotomy), closure of postpneumonectomy fistula, and right upper pulmonary lobectomy.
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