Comparison of the Effects of Lobectomy on Immunologic Function Between Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Non–Small-Cell Lung Cancer

Zhang, Liang; Ren, Yi; Liu, Yongyu

doi:10.1097/mjt.0000000000000254

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…However, major surgery for cancer is known to induce lymphopenia and suppress lymphocyte function ( 18 ). Similar to previous studies ( 19 , 20 ), we demonstrated a significant decrease in peripheral lymphocyte subpopulations at 1 day postoperatively in all patients. IFN-γ production has been demonstrated to be well-correlated with various activities of lymphocytes and can be utilized as a symbol of lymphocyte function ( 17 ).…”

Section: Discussionsupporting

confidence: 91%

Impact of Perioperative Multiple Doses of Glucocorticoids on Peripheral Blood Lymphocyte Subsets and Inflammatory Cytokines in Patients With Non-small Cell Lung Cancer

Yang

Cai

2022

Front. Surg.

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PurposeSurgery-induced immunosuppression is associated with infectious complications and cancer recurrence. This study aimed to characterize the effects of perioperative multiple doses of glucocorticoids on the peripheral immune environment in patients with non-small cell lung cancer.MethodsIn this retrospective study, surgical patients with lung cancer were included. Lymphocyte subsets, lymphocyte phenotypes, lymphocyte functions, and inflammatory cytokines were evaluated in the peripheral blood preoperatively, then at 1 day and 7 days postoperatively. Levels of immune cells and inflammatory factors were compared between those who did or did not receive glucocorticoids at all time points.ResultsMultiple doses or high doses (15–20 mg dexamethasone equivalents) of glucocorticoids that were all given within 24 h were associated with decreased absolute numbers of T cells, CD4+and CD8+T cells, B cells, and impaired T cells function at 1 day postoperatively while a single intraoperative low dose (5 mg) of dexamethasone had little influence on the peripheral environment. IL-1β, IL-6, and TNF-α were also more affected by multiple doses of glucocorticoids.ConclusionsAmong patients with lung cancer, perioperative multiple doses of glucocorticoids that are all given within a short time are associated with decreased immune cell counts and impaired T cells functions.

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Section: Discussionsupporting

confidence: 91%

Impact of Perioperative Multiple Doses of Glucocorticoids on Peripheral Blood Lymphocyte Subsets and Inflammatory Cytokines in Patients With Non-small Cell Lung Cancer

Yang

Cai

2022

Front. Surg.

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“…One hundred and sixty-nine reports of 145 studies met the predefined inclusion criteria and were included in the review. Seven studies were RCTs and included a total of 1,276 randomized patients, 19,94,111,126,168,169,171 and 138 studies including a total of 368,517 patients were nonrandomized cohort and case-control studies. In total the 145 studies included 369,793 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies including 332 patients measured quality of life using global QoL tools. 19,86,171 Pooled analysis showed significantly higher quality of life at 1 year in mVATS patients compared to open lobectomy (SMD 0.42; 95% CI, 0.20 to 0.64; P = 0.001). No heterogeneity was detected for this comparison (I 2 = 0%).…”

Section: Mvats Versus Open Lobectomymentioning

confidence: 99%

Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis

MacDonald

Gilbert

et al. 2019

Innovations�(Phila)

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Objective Video-assisted thoracic surgery (VATS) lobectomy was introduced over 25 years ago. More recently, the technique has been modified from a multiport video-assisted thoracic surgery (mVATS) to uniportal (uVATS) and robotic (rVATS), with proponents for each approach. Additionally most lobectomies are still performed using an open approach. We sought to provide evidence-based recommendations to help define the optimal surgical approach to lobectomy for early stage non-small cell lung cancer. Methods Systematic review and meta-analysis of articles searched without limits from January 2000 to January 2018 comparing open, mVATS, uVATS, and rVATS using sources Medline, Embase, and Cochrane Library were considered for inclusion. Articles were individually scrutinized by ISMICS consensus conference members, and evidence-based statements were created and consensus processes were used to determine the ensuing recommendations. The ACC/AHA Clinical Practice Guideline Recommendation Classification system was used to assess the overall quality of evidence and the strength of recommendations. Results and recommendations One hundred and forty-five studies met the predefined inclusion criteria and were included in the meta-analysis. Comparisons were analyzed between VATS and open, and between different VATS approaches looking at oncological outcomes (survival, recurrence, lymph node evaluation), safety (adverse events), function (pain, quality of life, pulmonary function), and cost-effectiveness. Fifteen statements addressing these areas achieved consensus. The highest level of evidence suggested that mVATS is preferable to open lobectomy with lower adverse events (36% versus 42%; 88,460 patients) and less pain (IIa recommendation). Our meta-analysis suggested that overall survival was better (IIb) with mVATS compared with open (71.5% versus 66.7% 5-years; 16,200 patients). Different VATS approaches were similar for most outcomes, although uVATS may be associated with less pain and analgesic requirements (IIb). Conclusions This meta-analysis supports the role of VATS lobectomy for non-small cell lung cancer. Apart from potentially less pain and analgesic requirement with uVATS, different minimally invasive surgical approaches appear to have similar outcomes.

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“…An immune response is involved during the lung surgery [28,29]. One-lung ventilation technique was consistently used during the pulmonary surgery.…”

Section: Discussionmentioning

confidence: 99%

Hydrogen-oxygen therapy improves postoperative pulmonary functions and accelerates recovery through attenuating inflammatory reactions and oxidative stress in patients undergoing lung surgery

Yang

Zhang

et al. 2022

Preprint

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Purpose: To investigate whether hydrogen-oxygen (67%–33%) therapy could improve the postoperative pulmonary function, recovery, complications, inflammatory reactions, and oxidative stress in patients undergoing lung surgery.Methods: We performed a prospective, randomized, single-blind, controlled clinical trial between December 2020 and December 2021. Eligible patients received either a lobectomy or sublobar resection. Postoperatively, they had 2-hour hydrogen-oxygen therapy (group H) or oxygen therapy (group C) daily, for three consecutive days. The pulmonary functions, recovery, pain intensity, oxygen saturation, inflammatory cytokines, and anti-oxidative markers were documented.Results: A total of 66 patients were analyzed, with 33 patients in each group. Both groups had decreased postoperative pulmonary functions, but group H had significantly better postoperative pulmonary functions than group C (forced vital capacities were 1.4±0.5 and 1.0±0.4 L and forced expiratory volumes in the first second were 1.1±0.3 and 0.9±0.3 L in group H and C, respectively (both P<0.01)). Compared to group C, group H had significantly decreased drainage volume, reduced catheter indwelling duration, shortened length of hospital stay, and lower pain intensity. Group H had statistically significantly decreased postoperative serum cytokine TNF-α and IL-6 levels and increased anti-oxidative markers compared to group C. The incidences of postoperative complications were comparable between the two groups. Conclusion: Hydrogen-oxygen therapy could improve postoperative pulmonary functions, decrease pain intensity, accelerate recovery, and shorten the length of the hospital stay in patients who have undergone lung resection, which may be related to its anti-inflammatory and anti-oxidative effects. Trial registration: The Chinese Clinical Trial Registry (registration number ChiCTR2100042101)，the date of registration was January,13,2021.

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Comparison of the Effects of Lobectomy on Immunologic Function Between Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Non–Small-Cell Lung Cancer

Cited by 8 publications

References 21 publications

Impact of Perioperative Multiple Doses of Glucocorticoids on Peripheral Blood Lymphocyte Subsets and Inflammatory Cytokines in Patients With Non-small Cell Lung Cancer

Impact of Perioperative Multiple Doses of Glucocorticoids on Peripheral Blood Lymphocyte Subsets and Inflammatory Cytokines in Patients With Non-small Cell Lung Cancer

Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis

Hydrogen-oxygen therapy improves postoperative pulmonary functions and accelerates recovery through attenuating inflammatory reactions and oxidative stress in patients undergoing lung surgery

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