Efficacy of thoracoscopic surgery in the treatment of lung cancer in the perioperative period and its effects on serum D-dimer

Abstract

The aim of this study was to investigate the feasibility and safety of thoracoscopic surgery in the treatment of lung cancer and its effect on serum D-dimer. A total of 218 patients with lung cancer treated in the Department of Thoracic Surgery of Ningbo No. 2 Hospital from January 1, 2013 to December 31, 2016, were retrospectively analyzed. Of the 218 patients, 120 patients underwent thoracotomy (thoracotomy group) and 98 patients underwent thoracoscopic surgery (thoracoscopy group). The clinical efficacy in the perioperative period and serum D-dimer level were compared between the two groups. In the present study, the intraoperative blood loss, blood transfusion rate, postoperative hospital stay, thoracic drainage time and volume in the thoracoscopy group were significantly shorter or smaller than those in the thoracotomy group (P<0.05), but there was no statistically significant difference in the average operation time between the thoracoscopy and the thoracotomy group. The incidence rate from moderate to severe pains in incisions after operation, the use rate of analgesics and the average disappearance time of the pain in incisions in the thoracoscopy were lower than those in the thoracotomy group (P<0.05). The amount of serum D-dimer immediately after operation in the thoracotomy group was significantly increased compared with that before operation (P<0.05), but there was no significant increase in the thoracoscopy group. At 24 h after operation, the serum D-dimer level in the two groups was further increased (P<0.05), and the comparison between the two groups showed that the levels of serum D-dimer in the thoracoscopy group immediately and at 24 h after operation were significantly lower than those in the thoracotomy group (P<0.05). The incidence rate of postoperative complications in the thoracoscopy was lower than that in the thoracotomy group, but the difference was not statistically significant. Our results show that thoracoscopic surgery is feasible and safe in the treatment of lung cancer. Compared with the thoracotomy group, the intraoperative condition and postoperative recovery have obvious advantages. The postoperative blood of patients is hypercoagulable and D-dimer increased gradually after 24 h. The effect of thoracoscopic surgery on serum D-dimer is relatively less effective.

Nonintubated Spontaneous Ventilation Offers Better Short-term Outcome for Mediastinal Tumor Surgery

“…The possible reasons to explain the benefit would be the effect of less anesthesia stimulation and less muscle relaxant. Previous findings have shown that the increase in serum D-dimer in open procedures was more obvious than that in the thoracoscopy group, 20 indicating a lower level of D-dimer change was associated with a more minimally invasive approach. Further prospective study should be conducted to validate the potential advantage of spontaneous ventilation on prevention of venous thrombus.…”

D‑dimer as a potential clinical marker for predicting metastasis and progression in cancer

“…D-dimer levels >0.55 mg/l were considered to be elevated, since this was the upper limit of the 90% confidence interval for the average value determined in the healthy volunteers. The D-dimer levels in tumor patients can be affected following surgery (25,26), chemotherapy (27,28) and adjuvant therapy (29). Therefore, the data analyzed herein is the D-dimer expression level of all patients prior to treatment.…”

Uniportal versus three‐port video‐assisted thoracoscopic surgery for non‐small cell lung cancer: A retrospective study

“…Compared with thoracotomy, multiportal VATS significantly reduces surgical trauma and postoperative complication rates and improves the quality of life after surgery 26 . Multiportal VATS is also significantly superior to thoracotomy in terms of the rates of surgical incision infection and postoperative cardiac and pulmonary complications 27–29 . This study shows that the rates of postoperative and pulmonary complications were similar between the groups.…”