Anatomy - Uniportal VATS mediastinal lymphadenectomy right

According to the IALSC lymph node map, thoracic lymph nodes are divided into 4 groups and a total of 14 stations.

• Upper mediastinal lymph nodes

Station 1 - Highest mediastinal LN - Above a horizontal line of the left brachiocephalic vein (upper edge)

Station 2 - Highest paratracheal LN - Below Station 1 and above a horizontal line at the level of the aortic arch

Station 3 - Prevascular LN - retrotracheal and prevascular LN

Station 4 - Lower paratracheal LN - between the aortic arch and the right or left main bronchus

• Aortic lymph nodes

Station 5 - Subaortic LN - Lateral to the ascending aorta and the aortic arch or brachiocephalic trunk

Station 6 - Para-aortic LN - Anterior and lateral to the ascending aorta and the aortic arch

• Lower mediastinal lymph nodes

Station 7 - Below the main bifurcation

Station 8 - Paraesophageal LN - Below the carina, adjacent to the esophageal wall

Station 9 - LN in the pulmonary ligament - Lymph nodes in the pulmonary ligament and basal part of the lower pulmonary vein

• N1 lymph nodes

Station 10 - Hilar lymph nodes

Station 11 - Interlobar lymph nodes

Station 12 - Lobar lymph nodes

Station 13 - Segmental lymph nodes

Station 14 - Subsegmental lymph nodes

• The mediastinal lymph nodes form the ipsilateral N2 lymph nodes and the contralateral N3 lymph nodes. The detection of malignant involvement of these stations is crucial for correct staging and subsequent therapy decision (surgery vs. systemic therapy).
• Supraclavicular lymph nodes are counted as Station 1 and represent N3 involvement.