大鼠模型中，与开放手术相比，视频辅助手术的围手术期免疫反应降低。
Reduced perioperative immune response in video-assisted versus open surgery in a rat model.
作者信息
Ito Yoshitaka, Oda Makoto, Tsunezuka Yoshio, Matsumoto Isao, Ishikawa Norihiko, Kawakami Kazuyuki, Ota Yasuhiko, Watanabe Go
机构信息
Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Ishikawa, Japan.
出版信息
Surg Today. 2009;39(8):682-8. doi: 10.1007/s00595-008-3935-z. Epub 2009 Jul 29.
PURPOSE
To establish the best technique for thoracoscopic pneumonectomy in the rat and to analyze the differences in perioperative immune response between open and video-assisted thoracoscopic surgery (VATS) in a rat model.
METHODS
The four experimental groups studied were as follows: VATS pneumonectomy, open pneumonectomy, thoracoscopic observation, and open observation. We measured the immunocyte counts and serum cytokine levels postoperatively in each group.
RESULTS
The CD3+, CD4+, and CD8+ lymphocyte counts were decreased significantly 12-24 h postoperatively in all groups. Immunosuppression peaked later in the open approach groups than in the VATS groups. The interleukin-6 level was significantly higher in the open approach groups than in the VATS groups.
CONCLUSIONS
From the viewpoint of immunity, in this rat model VATS was less invasive than open surgery, and open surgery caused greater immunosuppression than VATS, irrespective of organ resection.
目的
建立大鼠胸腔镜肺切除术的最佳技术，并分析大鼠模型中开胸手术与电视辅助胸腔镜手术（VATS）围手术期免疫反应的差异。
方法
所研究的四个实验组如下：VATS肺切除术、开胸肺切除术、胸腔镜观察和开胸观察。我们测量了每组术后的免疫细胞计数和血清细胞因子水平。
结果
所有组术后12 - 24小时CD3 +、CD4 +和CD8 +淋巴细胞计数均显著下降。开胸手术组的免疫抑制高峰出现时间晚于VATS组。开胸手术组的白细胞介素-6水平显著高于VATS组。
结论
从免疫角度来看，在该大鼠模型中，VATS的侵袭性小于开胸手术，且无论是否进行器官切除，开胸手术引起的免疫抑制均比VATS更大。
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