title: Role of oxidative stress and outcome of various surgical approaches among patients with bullous lung disease candidate for surgical interference.
abstract: BACKGROUND
  Bullous lung disease is characterized by formation of blebs, bullae and emphysema. We investigate the role of oxidative stress in the pathogenesis of bullous lung disease and compare between conventional thoracotomy versus video assisted thoracoscopic approach in surgical management of such patients.
  
  
  METHODS
  This study was a prospective case control study and it was carried out on 21 patients (16 males and 5 females) with bullous lung disease selected as candidate for surgical interference. This was in addition to 21 apparently healthy age and sex matched subjects selected as control group. Plasma levels of α1-antitrypsin were estimated using commercially available ELISA assay kit, while plasma levels of malondialdehyde (MDA), β-carotene, vitamin A, vitamin C and vitamin E were estimated using spectrophotometric methods. Conventional thoracotomy approach was done in thirteen patients, while, videothoracoscopic approach was done in eight patients.
  
  
  RESULTS
  There were significant higher plasma levels of MDA (P<0.001) and lower plasma levels of β-carotene (P<0.01), vitamin A, vitamin C and vitamin E (P<0.001 for each) among patients with bullous lung disease when compared with the control group. There was non-significant difference regarding the air leakage and the hospital stay among patients with bullous lung disease who managed via conventional thoracotomy approach when compared with those managed via videothoracoscopic approach.
  
  
  CONCLUSIONS
  This study proves that the oxidative stress plays an important role in the pathogenesis of bullous lung disease. Also there are no significant outcome differences between conventional thoracotomy versus video assisted thoracoscopic approach in surgical treatment of such patients.
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Farouk
authors.affiliation: Department of Medical Biochemistry and Molecular Biology, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Hassan
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Mohammed Alaa
authors.initials: MA
authors.lastname: Nady
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Mohammed Farouk
authors.initials: MF
authors.lastname: Abdel Hafez
keywords: Oxidative stress; bollous lung; surgical approach; α1-antitrypsin