The effects of robotic versus thoracoscopic lobectomy on body trauma and lymphocyte subsets in patients with non-small cell lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Qingyuan , TAO Shaolin , KANG Poming , FANG Chunshu , CHEN Dali , WU Licheng ,  TAN Qunyou

Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, P.R.China;

Corresponding author：

TAN Qunyou, Email: tanqy001@163.com

Keywords：

Non-small cell lung cancer; lobectomy; robotic surgery; thoracoscopic surgery; lymphocyte subsets

DOI：

10.7507/1007-4848.202011051

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effects of robotic versus thoracoscopic lobectomy on body trauma and lymphocyte subsets in patients with non-small cell lung cancer (NSCLC).Methods The clinical data of 120 patients with NSCLC who underwent lobectomy in the same operation group at the same period were collected and divided into a robot group (n=60) and a thoracoscope group (n=60) according to different surgical methods. The operation time, intraoperative blood loss, postoperative drainage time, drainage volume, postoperative hospital stay, complication rate, pain visual analogue scale (VAS) and other perioperative indicators were recorded in the two groups. Inflammatory markers: C-reactive protein (CRP), interleukin-6 (IL-6) and lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺) levels were measured before and 1 d, 3 d after surgery. The effects of the two surgical methods on the body trauma and lymphocyte subsets were compared.Results The operation time, intraoperative blood loss, postoperative drainage time, drainage volume and VAS of the robot group were lower than those of the thoracoscope group, and the differences were statistically significant (P<0.05). On the 1st day after surgery, IL-6 of the thoracoscope group was higher than that of the robot group, while CD3⁺, CD4⁺ and CD8⁺ were lower than those of the robot group, with statistically significant differences (P<0.05).Conclusion Compared with thoracoscopic lobectomy, robotic lobectomy has less trauma, less inflammatory response, faster recovery, less inhibitory effect on lymphocyte subsets, and has clinical advantages.

Citation： LI Qingyuan, TAO Shaolin, KANG Poming, FANG Chunshu, CHEN Dali, WU Licheng, TAN Qunyou. The effects of robotic versus thoracoscopic lobectomy on body trauma and lymphocyte subsets in patients with non-small cell lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(3): 299-304. doi: 10.7507/1007-4848.202011051 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Wang Z, Pang L, Tang J, et al. Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: a systematic review and meta-analysis. BMC Surg, 2019, 19(1): 144.
3.	Long H, Tan Q, Luo Q, et al. Thoracoscopic surgery versus thoracotomy for lung cancer: Short-term outcomes of a randomized trial. Ann Thorac Surg, 2018, 105(2): 386-392.
4.	Ikeda N. Updates on minimally invasive surgery in non-small cell lung cancer. Curr Treat Options Oncol, 2019, 20(2): 16.
5.	Zhang LB, Wang B, Wang XY, et al. Influence of video-assisted thoracoscopic lobectomy on immunological functions in non-small cell lung cancer patients. Med Oncol, 2015, 32(7): 201.
6.	张曦. 胸腔镜手术对早期肺癌施行根治术患者的免疫功能及生存期的影响分析. 中国临床医生杂志, 2018, 46(1): 50-53.
7.	李晓亮, 谢晓阳, 杨彦辉, 等. 全胸腔镜与后外侧开胸手术对非小细胞肺癌患者创伤指标、免疫功能及生活质量的影响. 临床肺科杂志, 2017, 22(7): 1189-1192.
8.	Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: a meta-analysis. Ann Surg, 2018, 268(2): 254-259.
9.	中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018 版). 中华肿瘤杂志, 2018, 40(12): 935-964.
10.	谭群友, 邓波, 康珀铭, 等. 276 例单操作孔全胸腔镜肺叶切除治疗早期非小细胞肺癌的围术期效果分析. 第三军医大学学报, 2012, 34(21): 2181-2183.
11.	许卫华, 温泽淮, 王奇. 重复测量资料的单独效应分析及多重比较. 广州中医药大学学报, 2017, 34(5): 766-770.
12.	Chan J, Yu P, Yang JH, et al. Surgical access trauma following minimally invasive thoracic surgery. Eur J Cardiothorac Surg, 2020, 58(Suppl_1): i6-i13.
13.	Zhang Y, Chen C, Hu J, et al. Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis. J Thorac Cardiovasc Surg, 2020, 160(5): 1363-1372.
14.	张大坤, 许世广, 丁仁泉, 等. 达芬奇机器人手术与胸腔镜辅助小切口手术对肺手术患者创伤对比分析. 创伤与急危重病医学, 2014, 2(5): 296-300.
15.	Jawa RS, Anillo S, Huntoon K, et al. Interleukin-6 in surgery, trauma, and critical care part Ⅱ: clinical implications. J Intensive Care Med, 2011, 26(2): 73-87.
16.	Golabek-Dropiewska K, Pawlowska J, Witkowski J, et al. Analysis of selected pro- and anti-inflammatory cytokines in patients with multiple injuries in the early period after trauma. Cent Eur J Immunol, 2018, 43(1): 42-49.
17.	Sun Z, Du C, Xu P, et al. Surgical trauma-induced CCL18 promotes recruitment of regulatory T cells and colon cancer progression. J Cell Physiol, 2019, 234(4): 4608-4616.
18.	蔡子仁, 王建, 周新明, 等. 开胸与胸腔镜手术影响肺癌患者术后调节 T 细胞功能和 T 淋巴细胞亚群的临床研究. 河北医药, 2019, 41(19): 2944-2947.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Wang Z, Pang L, Tang J, et al. Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: a systematic review and meta-analysis. BMC Surg, 2019, 19(1): 144.
3. Long H, Tan Q, Luo Q, et al. Thoracoscopic surgery versus thoracotomy for lung cancer: Short-term outcomes of a randomized trial. Ann Thorac Surg, 2018, 105(2): 386-392.
4. Ikeda N. Updates on minimally invasive surgery in non-small cell lung cancer. Curr Treat Options Oncol, 2019, 20(2): 16.
5. Zhang LB, Wang B, Wang XY, et al. Influence of video-assisted thoracoscopic lobectomy on immunological functions in non-small cell lung cancer patients. Med Oncol, 2015, 32(7): 201.
6. 张曦. 胸腔镜手术对早期肺癌施行根治术患者的免疫功能及生存期的影响分析. 中国临床医生杂志, 2018, 46(1): 50-53.
7. 李晓亮, 谢晓阳, 杨彦辉, 等. 全胸腔镜与后外侧开胸手术对非小细胞肺癌患者创伤指标、免疫功能及生活质量的影响. 临床肺科杂志, 2017, 22(7): 1189-1192.
8. Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: a meta-analysis. Ann Surg, 2018, 268(2): 254-259.
9. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018 版). 中华肿瘤杂志, 2018, 40(12): 935-964.
10. 谭群友, 邓波, 康珀铭, 等. 276 例单操作孔全胸腔镜肺叶切除治疗早期非小细胞肺癌的围术期效果分析. 第三军医大学学报, 2012, 34(21): 2181-2183.
11. 许卫华, 温泽淮, 王奇. 重复测量资料的单独效应分析及多重比较. 广州中医药大学学报, 2017, 34(5): 766-770.
12. Chan J, Yu P, Yang JH, et al. Surgical access trauma following minimally invasive thoracic surgery. Eur J Cardiothorac Surg, 2020, 58(Suppl_1): i6-i13.
13. Zhang Y, Chen C, Hu J, et al. Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis. J Thorac Cardiovasc Surg, 2020, 160(5): 1363-1372.
14. 张大坤, 许世广, 丁仁泉, 等. 达芬奇机器人手术与胸腔镜辅助小切口手术对肺手术患者创伤对比分析. 创伤与急危重病医学, 2014, 2(5): 296-300.
15. Jawa RS, Anillo S, Huntoon K, et al. Interleukin-6 in surgery, trauma, and critical care part Ⅱ: clinical implications. J Intensive Care Med, 2011, 26(2): 73-87.
16. Golabek-Dropiewska K, Pawlowska J, Witkowski J, et al. Analysis of selected pro- and anti-inflammatory cytokines in patients with multiple injuries in the early period after trauma. Cent Eur J Immunol, 2018, 43(1): 42-49.
17. Sun Z, Du C, Xu P, et al. Surgical trauma-induced CCL18 promotes recruitment of regulatory T cells and colon cancer progression. J Cell Physiol, 2019, 234(4): 4608-4616.
18. 蔡子仁, 王建, 周新明, 等. 开胸与胸腔镜手术影响肺癌患者术后调节 T 细胞功能和 T 淋巴细胞亚群的临床研究. 河北医药, 2019, 41(19): 2944-2947.

Previous Article
肝癌的影像学研究进展及其在多学科诊疗中的应用
Next Article
Clinical application of novel coronavirus infection rapid screening tool for liver transplantation donors

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The effects of robotic versus thoracoscopic lobectomy on body trauma and lymphocyte subsets in patients with non-small cell lung cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content