Video-assisted thoracic surgery for early stage lung cancer - can short-term immunological advantages improve long-term survival?
The development of video-assisted thoracic surgery (VATS) in the past decade has changed the way many pulmonary conditions are being treated. VATS has gained popularity among clinicians due to faster recovery following surgery, less postoperative pain and better cosmesis. It is well known that surgical trauma can induce a systemic inflammatory response and affect postoperative systemic immunity. Minimal access VATS has been shown to be associated with a reduced postoperative systemic inflammatory response. Recent evidence suggests VATS is also associated with better cellular immunity, and produces less immunochemokine disturbance following surgery, when compared with the thoracotomy approach. Circulating natural killer (NK) cell numbers and levels of insulin growth factor binding protein (IGFBP) are found to be higher, and plasma levels of matrix metalloproteinases are lower following VATS than that after thoracotomy. Maintenance of immune function with VATS may have important clinical implications in lung cancer surgery.
Ng
Calvin S H
CS
Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
Wan
Song
S
Hui
Connie W C
CW
Lee
Tak Wai
TW
Underwood
Malcolm J
MJ
Yim
Anthony P C
AP
D005500:Follow-Up Studies; D006801:Humans; D007111:Immunity, Cellular; D008175:Lung Neoplasms / Q000276:immunology / Q000401:mortality / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome