Evaluation of inflammatory-response-induced thoracoscopic surgical stress

Objective: Due to the paucity of reports evaluating stress induced by thoracoscopic surgery with minithoracotomy, we assessed this stress based on the inflammatory response to surgery.Methods: Differences in pre- and postoperative peripheral white blood cell (WBC) count, serum C-reactive protein (CRP), and serum interleukin-6 (IL-6) were evaluated, defined as dW, dCRP, and dIL-6. Thoracoscopic partial lung resection cases were divided into 2 groups by access route: Group A patients in which surgery was concluded via several small access ports. and Group B patients going surgery via small access ports plus minithoracotomy. We also compared dW in standard lobectomy with exploratory thoracotomy (thoracotomy without lobectomy) cases.Results: No significant difference was seen in dW, dCRP, or dIL-6 between groups. dW in response to exploratory thoracotomy was lower than that in standard lobectomy (p=0.06).Conclusions: Surgical stress induced by thoracoscopic partial lung resection does not increase significantly when minithoracotomy is added. Postoperative inflammatory response may, however, be influenced by the extent of surgical trauma.