Video-assisted thoracic surgery is minimally invasive, but is it less traumatic?
BACKGROUND
Video-assisted thoracic surgery (VATS) is a minimally invasive procedure. This study aimed to evaluate whether the procedure is less traumatic to the ipsilateral non-diseased lobe(s) than open thoracotomy (OT) during pulmonary resection by a comparison of alveolar-capillary membrane (A/C) permeability.


METHODS
Wedge resections were performed in twenty-seven patients with various types of primary and secondary malignant, solitary, pulmonary nodules. Fifteen patients had OT, while 12 patients had VATS. (99 m)Tc-DTPA radioaerosol studies were performed on the day before surgery and on the third or fourth day postoperatively. The images of the ipsilateral non-diseased lobe(s) were compared.


RESULTS
Postoperatively, all patients had significantly increased A/C permeability at the ipsilateral non-diseased lobe(s). However, the degree of increase in the VATS group was the same as that of the OT group. Postoperative A/C permeability of the contralateral lung was not significantly different.


CONCLUSIONS
Both procedures caused injury to the ipsilateral non-diseased lobe(s) in terms of A/C permeability at the same degree. Although VATS has been considered as a minimally invasive procedure, the trauma caused by VATS to the "disease-free lung" is the same as that caused by open thoracotomy.
Chou
S-H
SH
Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. shhwch@cc.kmu.edu.tw
Chen
Y-W
YW
Kao
E-L
EL
Chuang
H-Y
HY
Dai
Z-K
ZK
Huang
M-F
MF
D000293:Adolescent; D000328:Adult; D000368:Aged; D002199:Capillary Permeability / Q000187:drug effects*; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012720:Severity of Illness Index; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis / Q000601:surgery; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics*; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000592:standards; D013908:Thoracotomy
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate