The Effect Of Video-assisted Thoracoscopic Surgery(VATS) And Video-assisted Mini-thoracotomy(VAMT) On C-reactive Protein And Procalcitonin And Some Immunological Indexes After Radical Resection Of Lung Cancer

Objective:To investigate the differences of C-reactive protein(CRP),procalcitonin(procalcitonin)and immunological indexes between thoracoscopic surgery(video-assisted thoracoscopic surgery,VATS)and thoracoscopic minimal incision surgery(video-assisted mini-thoracotomy,VAMT)after radical resection of lung cancer.Methods:We used a prospective study to test 102 patients who were treated by thoracoscopic surgery from October 2016 to August 2018 in the department of thoracic surgery of First Hospital of Jilin university.,and combined with the needs and personal wishes of the patients,According to the patient’s needs,personal wishes and intraoperative conditions,54 patients who underwent thoracoscopic surgery(VATS)were included in VATS group and 48 patients who underwent VAMT were included in VAMT group.Fasting venous blood was collected 1 day before operation and 1,3,7day after operation.The levels of protein,CRP,Procalcitonin,PCT,CD3,CD4,CD4 / CD8 and IgG,IgM,IgA were compared.Result:There was no significant difference in preoperative data(sex,age,tumor volume,tumor location,pathological origin)between the two groups,Also the level of CRP,PCT of the 1st day before operation shows no difference between the two groups(P > 0.05).There was no significant difference of CRP between the two groups on the 1st day before operation(P>0.05).At 24 h,72 h and 1week after the operation,the level of CRP in the VATS group was significantly lower than that of VAMT group(P < 0.05).There was statistical significance in the interaction of different surgical methods and different time.(P < 0.05).There was no significant difference of PCT between the two groups on the 1st day before operation(P > 0.05).The level of the PCT at 24 h,72h and 1week after operation of VATS group was significantly lower than those of VAMT group(P < 0.01).It shows significantly difference of levels of the PCT in the different operation methods and different times between the two groups.The interaction between the two groups was statistically significant(P < 0.05).The levels of CD3 +,CD4 +,CD4 +/ CD8 + were not significantly different in the two groups(P> 0.05).The percentage of CD3 +,CD4 +,CD4 +/ CD8 + in patients with VATS group was significantly higher than that of the VAMT group(P <0.05).There was a major difference in the level of T lymphocyte(P <0.01),and there was an interaction between different operation methods and different time(P <0.05).There was no significant difference in the level of IgA,IgM between the two groups before the operation(P > 0.05).The IgG level of 72 h and 1week after the operation of VATS group was significantly higher than that of the VAMT group(P <0.05).The level of immunoglobulin,which was not different between the two groups(P>0.05),was significantly differenton time after the operation(P<0.01).There was no significant difference on the level of immunoglobulin between the two groups(P < 0.01).The level of IgG interacted with each other in different operation mode and time(P<0.05),and the level of IgM,IgA was different in different operation mode and time(P < 0.05).There was no interaction at discrete time.Conclusion:video-assisted thoracoscopic surgery(VATS),compared with video-assisted mini-thoracotomy(VAMT),can improve the preoperative index,reduce the effect on the immune function of patients,level of inflammatory reaction and the risk of postoperative infection.