目的:系统淋巴结清扫是局部晚期非小细胞肺癌手术治疗的重要组成部分,关于该术式的改良,目前文献较少.本文报告了一种基于单中心经验改良的胸腔镜下局部晚期非小细胞肺癌系统纵隔淋巴结清扫术——平行向上法(PUD法)并评估其疗效.方法:对PUD术式的设计理念和具体操作细节进行介绍;通过回顾性分析,总结中南大学湘雅二医院胸外科(2012年至2020年)采用PUD术式进行手术的998例局部晚期非小细胞肺癌患者围手术期病死率及一般并发症和严重并发症(如喉返神经损伤、支气管胸膜瘘等)的发生率.结果:998例患者均顺利完成PUD术式.统计PUD术式的患者术后并发症,发现仅有少数一般术后并发症发生,没有喉返神经损伤、支气管损伤及围手术期死亡发生.结论:PUD法安全且有效,可以作为目前系统纵隔淋巴结清扫术的有益补充.“,”Objective: Systematic nodal dissection (SND) is an important component of locally advanced non-small cell lung cancer (NSCLC), but modification of this procedure is rarely reported. In this paper, we reported a modified technique of systematic mediastinal lymph node dissection (MLND) of operable lung cancer by video-assisted thoracic surgery (VATS). Parallel upward dissection (the PUD technique) was named due to this modification and the efficacy of the PUD technique was evaluated as well.Methods: We summarized the tips of the PUD technique and its version was updated in surgical aspect. The design and procedure sequence of the PUD technique were introduced in detail as well as its pros and cons. A retrospective study was performed on 998 cases of locally advanced NSCLC which accepted the PUD procedure in Department of Thoracic Surgery, Second Xiangya Hospital, Central South University, from 2012 to 2020. The perioperative mortality and the incidence of general and serious complications (such as recurrent laryngeal nerve injury, bronchopleural fistula) were analyzed. Results: All the 998 cases were operated successfully with the PUD technique and few post-operation complications were found. There was no perioperative mortality and severe complication such as recurrent laryngeal nerve injury and bronchopleural fistula. Conclusion:The PUD technique is safe and convenient and it can be a good supplement to the existing surgical techniques for locally advanced lung cancer.