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Int. J. Mol. Sci. 2017, 18(7), 1466; doi:10.3390/ijms18071466

Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy

1
Department of Surgery and Experimental Medicine, Tor Vergata University of Rome, Rome 00173, Italy
2
Department of Thoracic Surgery, Official Awake Thoracic Surgery Research Group, Policlinico Tor Vergata University of Rome, Roma 00133, Italy
*
Author to whom correspondence should be addressed.
Received: 4 April 2017 / Revised: 20 June 2017 / Accepted: 28 June 2017 / Published: 7 July 2017
(This article belongs to the Special Issue Inflammation and Cancer)
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Abstract

Background: We hypothesized that video-assisted thoracic surgery (VATS) lung metastasectomy under non-intubated anesthesia may have a lesser immunological and inflammatory impact than the same procedure under general anesthesia. Methods: Between December 2005 and October 2015, 55 patients with pulmonary oligometastases (at the first episode) successfully underwent VATS metastasectomy under non-intubated anesthesia. Lymphocytes subpopulation and interleukins 6 and 10 were measured at different intervals and matched with a control group composed of 13 patients with similar clinical features who refused non-intubated surgery. Results: The non-intubated group demonstrated a lesser reduction of natural killer lymphocytes at 7 days from the procedure (p = 0.04) compared to control. Furthermore, the group revealed a lesser spillage of interleukin 6 after 1 (p = 0.03), 7 (p = 0.04), and 14 (p = 0.05) days. There was no mortality in any groups. Major morbidity rate was significantly higher in the general anesthesia group 3 (5%) vs. 3 (23%) (p = 0.04). The median hospital stay was 3.0 vs. 3.7 (p = 0.033) days, the estimated costs with the non-intubated procedure was significantly lower, even excluding the hospital stay. Conclusions: VATS lung metastasectomy in non-intubated anesthesia had significantly lesser impact on both immunological and inflammatory response compared to traditional procedure in intubated general anesthesia. View Full-Text
Keywords: lung metastases; non-intubated surgery; video-assisted thoracic surgery lung metastases; non-intubated surgery; video-assisted thoracic surgery
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Mineo, T.C.; Sellitri, F.; Vanni, G.; Gallina, F.T.; Ambrogi, V. Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy. Int. J. Mol. Sci. 2017, 18, 1466.

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