Original articleVATS lobectomy reduces cytokine responses compared with conventional surgery
Section snippets
Material and methods
From January 1997 to December 1998, 38 patients with clinical stage I nonsmall cell lung cancer and tumor size less than 4 cm in maximal diameter were recruited into the study. There were 24 men and 14 women (mean age, 62 years; range, 53 to 88 years). Routine mediastinoscopy was performed on all patients, among whom 2 were diagnosed to have N2 disease. These 2 patients received neoadjuvant chemotherapy and were excluded from the final analysis. The remaining 36 patients underwent routine VATS
Results
Because of the design of the study, we finished recruiting the 18 patients in the VATS group before we finished with the open group (n = 18). There was no difference between the two groups with respect to preoperative pulmonary function (forced expiratory volume in 1 second and forced vital capacity), smoking history and comorbidity. No mortality or intraoperative complications were encountered in either group, and no conversion occurred in the VATS group. The demographics, nature of the
Comment
Our data suggests that in comparison with the conventional open approach, VATS lobectomy is associated with a lesser release of both proinflammatory and antiinflammatory cytokines, indicating a reduced as well as balanced postoperative inflammatory reaction.
Inflammatory response serves a protective function to the body that could become harmful when it reaches a pathologic and systemic level. Recent studies of laparoscopic versus open procedures demonstrate that the degree of such an
Acknowledgements
This work was supported by a grant from the Research Grant Council of the Hong Kong Special Administrative Region (CUHK 280/96 mol/L).
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