title: Evaluation of inflammatory-response-induced thoracoscopic surgical stress.
abstract: OBJECTIVE
  Due to the paucity of reports evaluating stress induced by thoracoscopic surgery with minithoracotomy, we assessed this stress based on the inflammatory response to surgery.
  
  
  METHODS
  Differences in pre- and postoperative peripheral white blood cell (WBC) count, serum C-reactive protein (CRP), and serum interleukin-6 (IL-6) were evaluated, defined as dW, dCRP, and dIL-6. Thoracoscopic partial lung resection cases were divided into 2 groups by access route: Group A patients in which surgery was concluded via several small access ports. and Group B patients going surgery via small access ports plus minithoracotomy. We also compared dW in standard lobectomy with exploratory thoracotomy (thoracotomy without lobectomy) cases.
  
  
  RESULTS
  No significant difference was seen in dW, dCRP, or dIL-6 between groups. dW in response to exploratory thoracotomy was lower than that in standard lobectomy (p = 0.06).
  
  
  CONCLUSIONS
  Surgical stress induced by thoracoscopic partial lung resection does not increase significantly when minithoracotomy is added. Postoperative inflammatory response may, however, be influenced by the extent of surgical trauma.
authors.affiliation: Surgical Operation Center, Ryukyus University Hospital, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Kuda
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kamada
authors.forename: Naoji
authors.initials: N
authors.lastname: Nagamine
authors.forename: Jun
authors.initials: J
authors.lastname: Oshiro
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kuniyoshi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Genka
authors.forename: Kageharu
authors.initials: K
authors.lastname: Koja
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D013312:Stress, Physiological / Q000097:blood* / Q000209:etiology; D013906:Thoracoscopy / Q000009:adverse effects*; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein