| Title |
Video-assisted thoracic surgery reduces early postoperative stress. A single-institutional prospective randomized study
|
|---|---|
| Published in |
Therapeutics and Clinical Risk Management, January 2016
|
| DOI | 10.2147/tcrm.s95235 |
| Pubmed ID | |
| Authors |
Christos Asteriou, Achilleas Lazopoulos, Thomas Rallis, Apostolos S Gogakos, Dimitrios Paliouras, Kosmas Tsakiridis, Athanasios Zissimopoulos, Drosos Tsavlis, Konstantinos Porpodis, Wolfgang Hohenforst-Schmidt, Ioannis Kioumis, John Organtzis, Konstantinos Zarogoulidis, Paul Zarogoulidis, Nikolaos Barbetakis |
| Abstract |
Video-assisted thoracic surgery (VATS) has been shown to effectively reduce postoperative pain, enhance mobilization of the patients, shorten in-hospital length of stay, and minimize postoperative morbidity rates. The aim of this prospective study is to evaluate neuroendocrine and respiratory parameters as stress markers in cancer patients who underwent lung wedge resections, using both mini muscle-sparing thoracotomy and VATS approach. The patients were randomly allocated into two groups: Group A (n=30) involved patients who were operated on using the VATS approach, while in group B (n=30), the mini muscle-sparing thoracotomy approach was used. Neuroendocrine and biological variables assessed included blood glucose levels, C-reactive protein (CRP) levels, cortisol, epinephrine, and adrenocorticotropic hormone (ACTH) levels. Arterial oxygen (PaO2) and carbon dioxide (PaCO2) partial pressure were also evaluated. All parameters were measured at the following time points: 24 hours preoperatively (T1), 4 hours (T2), 24 hours (T3), 48 hours (T4), and 72 hours (T5), after the procedure. PaO2 levels were significantly higher 4 and 24 hours postoperatively in group A vs group B, respectively (T2: 94.3 vs 77.9 mmHg, P=0.015, T3: 96.4 vs 88.7 mmHg, P=0.034). Blood glucose (T2: 148 vs 163 mg/dL, P=0.045, T3: 133 vs 159 mg/dL, P=0.009) and CRP values (T2: 1.6 vs 2.5 mg/dL, P=0.024, T3: 1.5 vs 2.1 mg/dL, P=0.044) were found increased in both groups 4 and 24 hours after the procedure. However, their levels were significantly lower in the VATS group of patients. ACTH and cortisol values were elevated immediately after the operation and became normal after 48 hours in both groups, without significant difference. Postoperative epinephrine levels measured in group A vs group B, respectively, (T2: 78.9 vs 115.6 ng/L, P=0.007, T3: 83.4 vs 122.5 ng/L, P=0.012, T4: 67.4 vs 102.6 ng/L, P=0.021). The levels were significantly higher in group B. This study confirmed that minimally invasive thoracic surgery, by means of VATS, significantly reduces the acute-phase response and surgical stress, while enables better postoperative oxygenation. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 14% |
| Student > Ph. D. Student | 4 | 11% |
| Student > Doctoral Student | 4 | 11% |
| Student > Master | 3 | 9% |
| Researcher | 2 | 6% |
| Other | 7 | 20% |
| Unknown | 10 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 51% |
| Nursing and Health Professions | 4 | 11% |
| Psychology | 1 | 3% |
| Environmental Science | 1 | 3% |
| Unknown | 11 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 January 2016.
All research outputs
#19,944,994
of 25,374,647 outputs
Outputs from Therapeutics and Clinical Risk Management
#1,020
of 1,323 outputs
Outputs of similar age
#278,489
of 399,679 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#48
of 55 outputs
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