Planned resection of the regional lymph nodes in pneumonectomy for carcinoma.

Although there has been a reluctance to include the regional lymph nodes in pneumonectomy for cancer because of the supposed inaccessibility of the nodes, radical removal of the nodes within the thorax is a feasible procedure. Failure to include the regional nodes in pneumonectomy for cancer violates the accepted principle of inclusion of the regional lymphatics in operations for cancer. If pneumonectomy is indicated for removal of a malignant lesion, then removal of the regional nodes is also indicated. Injection of a dye helps the surgeon in identification of lymphatics to be excised.