Comparison of acute phase protein and hemodynamic variables in dogs undergoing video-assisted thoracoscopic vs. open pneumonectomy

Abstract

Abstract. It has been demonstrated that video-assisted thoracoscopic surgery (VATS) is feasible and safe in humans and animal models. The aim of the present study was to compare the surgical outcome using VATS with that of the standard transthoracic approach for pneumonectomy in dogs, to determine the acute-phase reaction in VATS pneumonectomy, and to analyze the difference between VATS and the standard transthoracic approach. A total of 14 dogs were divided into two groups (n=7); one group underwent VATS and the other group underwent a transthoracic pneumonectomy. Pre-, intraand post-operative physiologic parameters were monitored, in addition to the blood cell count and serum acute-phase protein (APP) concentrations. The APP and hemodynamic changes between the two approaches were analyzed. Mean surgical time in the VATS group (176.7 min) was significantly longer compared with the open group (132.4 min). All APP concentrations were significantly increased at day 1 postoperation and gradually decreased to preoperative concentrations. The serum concentration of C-reactive protein on day 3 and the white blood cell count on day 1 were significantly higher following surgery in the open group compared with the VATS group (P<0.05). No differences were observed in the physiological parameters between the two groups. Although VATS took longer, animals experienced smaller incision and less stress. Therefore, the VATS approach was satisfactory for total pneumonectomy.

Minimally Invasive Approaches Do Not Compromise Outcomes for Pneumonectomy: A Comparison Using the National Cancer Database

“…Animal experiments show potential benefits for thoracoscopic approaches to pneumonectomy. Liu et al 23 studied acute phase reactive proteins in dogs undergoing whole-lung resection by VATS compared to thoracotomy. Despite longer operative times, serum markers of inflammation including C-reactive protein on postoperative day (POD) 3 and the leukocyte count on POD 1 were significantly lower for the VATS cohort.…”

Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer

“…We showed that VATS was associated with a signi cantly shorter wound length and operation time, and lower postCRP level in comparison to thoracotomy in patients who underwent surgery for NSCLC. VATS has been reported to be associated with less pain, a shorter hospital stay and a reduced cytokine response in comparison to thoracotomy [4][5][6][7][8][9][10]. CRP and interleukin (IL)-6 have often been analyzed as parameters of operative invasiveness, and in patients who undergo VATS, these values are signi cantly lower in comparison to those who undergo thoracotomy [8][9][10].…”

“…VATS has been reported to be associated with less pain, a shorter hospital stay and a reduced cytokine response in comparison to thoracotomy [4][5][6][7][8][9][10]. CRP and interleukin (IL)-6 have often been analyzed as parameters of operative invasiveness, and in patients who undergo VATS, these values are signi cantly lower in comparison to those who undergo thoracotomy [8][9][10]. In the present study, the operation time and wound length were positively correlated with the postCRP level; thus, it was suggested that the operation time and wound length are associated with operative invasiveness and that VATS is less invasive approach.…”

“…The relationship between operative invasiveness, including the postoperative in ammatory response, and the prognosis of NSCLC patients who undergo surgery has not been clear. VATS has been reported to result in reduced postoperative CRP and IL-6 levels in comparison to thoracotomy [8][9][10][13][14][15][16]. IL-6 has been reported to promote cell proliferation [17][18][19][20], affect insulin growth factor (IGF), and result in insulin growth factor binding protein (IGFBP) 3 inhibition, thereby contributing to an environment favoring tumor proliferation in patients with NSCLC [21,22].…”

“…Furthermore, it was reported that VATS is associated with signi cantly less response in Creactive protein (CRP) and cytokine levels. Acute-phase proteins (APPs) are a series of proteins that are sensitive to in ammation and body stress including infection, surgical trauma, certain diseases and tissue damage [8][9]. The concentrations of certain APPs, including CRP may increase markedly during stress or under pathological conditions.…”