title: Video-assisted thoracic surgery is minimally invasive, but is it less traumatic?
abstract: 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.
authors.affiliation: Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. shhwch@cc.kmu.edu.tw
authors.forename: S-H
authors.initials: SH
authors.lastname: Chou
authors.forename: Y-W
authors.initials: YW
authors.lastname: Chen
authors.forename: E-L
authors.initials: EL
authors.lastname: Kao
authors.forename: H-Y
authors.initials: HY
authors.lastname: Chuang
authors.forename: Z-K
authors.initials: ZK
authors.lastname: Dai
authors.forename: M-F
authors.initials: MF
authors.lastname: Huang
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate