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：

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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

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14.	張大坤, 許世廣, 丁仁泉, 等. 達芬奇機器人手術與胸腔鏡輔助小切口手術對肺手術患者創傷對比分析. 創傷與急危重病醫學, 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. 開胸與胸腔鏡手術影響肺癌患者術后調節 T 細胞功能和 T 淋巴細胞亞群的臨床研究. 河北醫藥, 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. 張曦. 胸腔鏡手術對早期肺癌施行根治術患者的免疫功能及生存期的影響分析. 中國臨床醫生雜志, 2018, 46(1): 50-53.
7. 李曉亮, 謝曉陽, 楊彥輝, 等. 全胸腔鏡與后外側開胸手術對非小細胞肺癌患者創傷指標、免疫功能及生活質量的影響. 臨床肺科雜志, 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. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018 版). 中華腫瘤雜志, 2018, 40(12): 935-964.
10. 譚群友, 鄧波, 康珀銘, 等. 276 例單操作孔全胸腔鏡肺葉切除治療早期非小細胞肺癌的圍術期效果分析. 第三軍醫大學學報, 2012, 34(21): 2181-2183.
11. 許衛華, 溫澤淮, 王奇. 重復測量資料的單獨效應分析及多重比較. 廣州中醫藥大學學報, 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. 張大坤, 許世廣, 丁仁泉, 等. 達芬奇機器人手術與胸腔鏡輔助小切口手術對肺手術患者創傷對比分析. 創傷與急危重病醫學, 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. 開胸與胸腔鏡手術影響肺癌患者術后調節 T 細胞功能和 T 淋巴細胞亞群的臨床研究. 河北醫藥, 2019, 41(19): 2944-2947.

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

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