A Comparative Study Of Surgical Trauma In Video-Assisted Thoracoscopic Surgery And Conventional Thoracotomy Surgery

Objective: (1) Animal model research: A attempt to expound the relationship of surgical trauma between different operative incisions; (2) Clinical study: to evaluate the surgical trauma in video-assisted thoracoscopic surgery (VATS) and conventional thoracotomy surgery. Methods: (1) In animal research: 30 SD rats were divided into three groups randomly. Group A (n=10) underwent simulative video-assisted thoracoscope, group B (n=10) underwent conventional lateral thoracotomy and group C (n=10) underwent conventional sternotomy. Blood samples were taken for the determination of serum interlukin-6 (IL-6) , interlukin-8 (IL-8) , and tumor necrosis factor-α(TNF-α) before and at 12, 24, 48 hours after operation to evaluate the surgical trauma; (2) Clinical study: There were 39 patients who underwent video-assisted thoracoscopic surgery (VATS group) and 42 patients undergoing conventional thoracotomic surgery (CTH group). Blood samples were taken for the determination of serum C-reactive protein (CRP), IL-6, IL-8, and TNF-αbefore and 1, 2, 3 days after the operation to evaluate the surgical trauma. And the total operating time, extracorporeal circulation time, blood loss, pain management and postoperative hospital stay were collected in these two groups. Results: (1) In animal research: The levels of IL-6, IL-8, TNF-αat 12, 24, 48 hours after surgery in group A were lower than that in group B and group C (P<0.05) , but there was no difference between group B and group C. (2) In clinical study: The levels of CRP, IL-6, IL-8, TNF-αin 1, 2, 3 days after surgery in the VATS group were lower than that in the CTH group (P<0.05) . Compared with CTH group, VATS group had less blood loss, less pain and short time of hospital stay after surgery. There was no difference in the extracorporeal circulation duration between VATS group and CTH group. Conclusion: (1) Different operative incisions had different degree of surgical trauma. The operative incision of VATS was less trauma to the rats than of lateral thoracotomy and sternotomy. There was no significant difference between lateral thoracotomy and...