title: Immunologic and stress responses following video-assisted thoracic surgery and open pulmonary lobectomy in early stage lung cancer.
abstract: Conventional open major surgery evokes an injury response involving endocrine, neural, and immunologic mechanisms. The immunologic responses are characterized by release of cytokines, inflammatory mediators, and acute-phase proteins and by adverse disturbances in immune cell function. The use of a minimal access approach strategy is associated with a significant reduction in the cytokine response, as exemplified by reduced interleukin-6 levels and a corresponding reduction in acute-phase protein generation with reduced C-reactive protein levels. Circulating immune cell function and numbers also are better preserved. These changes have been demonstrated in comparing open with video-assisted thoracoscopic surgery (VATS) lobectomy and, together with further investigation into local immune function, may offer some insight into the excellent survival data reported for VATS resection of stage I non-small cell lung cancer.
authors.affiliation: Department of Thoracic Surgery, Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, Scotland, UK. wsw@holyrood.ed.ac.uk
authors.forename: William S
authors.initials: WS
authors.lastname: Walker
authors.forename: H Anne
authors.initials: HA
authors.lastname: Leaver
mesh_terms: D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007109:Immunity; D008175:Lung Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D013312:Stress, Physiological; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*
chemical_list: D016207:Cytokines