Video-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy.
OBJECTIVE
We studied cytokine changes after video-assisted thoracoscopic lobectomy and conventional lobectomy in patients with stage IA lung cancer.


METHODS
From June, 1997, 20 consecutive patients with stage IA non small-cell lung carcinoma underwent either conventional lobectomy via an open thoracotomy (n = 10) or video-assisted thoracoscopic lobectomy (n = 10). The cytokine concentration in serum and pleural fluid were measured for 6 days postoperatively.


RESULTS
Interleukin-6 and interleukin-8 leads peaked at 3 h or 1 day after surgery. Cytokine levels in pleural fluid were more than 100 times higher than corresponding systemic levels. The increase of interleukin-6 in pleural fluid 3 hours after surgery was significantly smaller in video-assisted thoracoscopic lobectomy (3971 +/- 2793 pg/mL for video-assisted thoracoscopic lobectomy vs. 23274 +/- 8426 pg/mL for open lobectomy). There were no significant differences in the serum interleukin-6 and interleukin-8 concentrations between the 2 groups.


CONCLUSIONS
The thoracoscopic approach lessened the increase of cytokines in pleural fluid, but benefits of reduced cytokine production in video-assisted thoracoscopy remain to be clarified.
Sugi
K
K
Department of Clinical Research, National Sanyo Hospital, Yamaguchi, Japan.
Kaneda
Y
Y
Esato
K
K
D018288:Carcinoma, Small Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D016209:Interleukin-8 / Q000032:analysis* / Q000097:blood; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000737:chemistry; D011013:Pneumonectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted
D015850:Interleukin-6; D016209:Interleukin-8