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Int. J. Mol. Sci. 2017, 18(7), 1466;

Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy

Department of Surgery and Experimental Medicine, Tor Vergata University of Rome, Rome 00173, Italy
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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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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