Shirai Suguru, Yamauchi Yoshikane, Yokote Fumi, Sakai Takashi, Saito Yuichi, Sakao Yukinori, Kawamura Masafumi
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2019 Dec;11(12):5382-5389. doi: 10.21037/jtd.2019.12.08.
The present study was performed to investigate the perioperative dynamics of coagulation factor XIII (FXIII) in patients with non-small cell lung cancer undergoing video-assisted thoracoscopic surgery (VATS) lobectomy compared with open lobectomy.
Perioperative coagulation factors including FXIII were analyzed in 30 patients who underwent VATS lobectomy and 10 patients who underwent open lobectomy at Teikyo University Hospital from December 2017 to April 2019.
Patients in the VATS lobectomy group showed higher FXIII activity on postoperative day (POD) 5 than patients in the open lobectomy group (P=0.028). The FXIII activity was significantly lower on POD3, POD5, and POD7 than that in the preoperative period and on POD1, even in patients who had undergone VATS lobectomy (P<0.001). No factors were found to affect the maintenance of FXIII in the VATS lobectomy group.
The postoperative decrease of FXIII activity differed between patients who underwent VATS lobectomy and those who underwent open lobectomy. Based on the characteristics of FXIII, the FXIII activity may be a good marker of the invasiveness of VATS lobectomy versus open lobectomy.
本研究旨在调查与开胸肺叶切除术相比,接受电视辅助胸腔镜手术(VATS)肺叶切除术的非小细胞肺癌患者围手术期凝血因子 XIII(FXIII)的动态变化。
2017 年 12 月至 2019 年 4 月期间,在帝京大学医院对 30 例行 VATS 肺叶切除术的患者和 10 例行开胸肺叶切除术的患者进行了包括 FXIII 在内的围手术期凝血因子分析。
VATS 肺叶切除术组患者术后第 5 天的 FXIII 活性高于开胸肺叶切除术组患者(P = 0.028)。即使是接受 VATS 肺叶切除术的患者,术后第 3 天、第 5 天和第 7 天的 FXIII 活性也显著低于术前及术后第 1 天(P < 0.001)。未发现影响 VATS 肺叶切除术组 FXIII 维持的因素。
接受 VATS 肺叶切除术的患者与接受开胸肺叶切除术的患者术后 FXIII 活性下降情况不同。基于 FXIII 的特性,FXIII 活性可能是 VATS 肺叶切除术与开胸肺叶切除术侵袭性的良好标志物。