C-Reactive Protein and Fibrinogen as Indicators of Systemic Inflammatory Response in Patients Undergoing VATS and Conventional Pulmonary Lobectomy

Abstract

Introduction. There is still ongoing discussion about superiority of video-assisted thoracoscopic surgery or VATS approach for performing lobectomy over conventional pulmonary lobectomy performed by open thoracotomy for the treatment of non-small cell lung cancer at an early stage. Aim of the study. This encouraged us to conduct a prospective study for evaluation and comparison of the systemic inflammatory response by using these two approaches. Materials and methods. We have conducted a prospective study for evaluation of C-reactive protein and Fibrinogen as indicators of systemic inflammatory response during early postoperative course. Surgery was prospectively randomised in two groups: 15 patients underwent VATS lobectomy and 15 patients underwent conventional open lobectomy. Blood samples were taken preoperatively, 24 and 72 hours after operation, on the day of drain removal, and 1 and 9 days after the drain removal. Results. Surgery caused systemic inflammatory response in both groups. The increase in CRP was notably higher in OL group in all measurements except preoperative (p<0,05). The increase in Fibrinogen concentrations was also higher in OL group but statistical significance (p<0,05) was reached only in day of drain removal. Conclusions. VATS approach caused reduced systemic inflammatory response compared with conventional open thoracotomy approach and was also associated with lesser postoperative pain as duration of chest drains and total amount of drained effusion is significantly smaller.