[Injuries after lobectomy: a prospective randomized comparison of video-assisted thoracoscopic surgery and mini-thoracotomy].
OBJECTIVE
To compare the differences of injuries and recovery between video-assisted thoracoscopic surgery (VATS) and mini-thoracotomy (MT) in patients with clinical early stage non-small cell lung cancer (NSCLC) after lobectomy.


METHODS
From March 2004 to December 2006, 47 consecutive patients with early stage NSCLC with a diameter of tumor less than 6 cm were recruited and randomized to VATS group and MT group. Incision length, duration of operation and intraoperative blood loss were recorded. Postoperative pain was assessed using a visual analogue scale before operation and daily for the first 7 days after operation. The serum levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured by cytometric bead array before operation and at 4, 24, and 48 h after operation. Karnofsky performance status (KPS) was assessed before operation and daily for the first 7 days after operation.


RESULTS
Incision length was (6.0 +/- 0. 9) cm in the VATS group and (12.5 +/- 1.5) cm in the MT group. There was no significant difference in duration of operation and intraoperative blood loss between the VATS group and the MT group. Postoperative pain was significantly less in the VATS group in the 5th to 7th day postoperatively (P < 0.05). There was no significant difference of serum concentrations of IL-6 and IL-10 between the VATS group and the MT group at 4, 24, and 48 h after operation. KPS score was significantly higher in the VATS group on 2nd to 7th day postoperatively (P < 0.05).


CONCLUSIONS
Compared with MT, VATS for lobectomy has less postoperative pain, faster recovery, but can't reduce postoperative release of cytokines.
Long
Hao
H
State Key Laboratory of Oncology in South China, Lung Cancer Research Center, Sun Yat-sen University, Guangzhou 510060, China. drlongh@medmail.com.cn
Lin
Zhi-chao
ZC
Situ
Dong-rong
DR
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D011013:Pneumonectomy / Q000379:methods*; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy