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Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy

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 pulmo...

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Autores principales: Mineo, Tommaso Claudio, Sellitri, Francesco, Vanni, Gianluca, Gallina, Filippo Tommaso, Ambrogi, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535957/
https://www.ncbi.nlm.nih.gov/pubmed/28686211
http://dx.doi.org/10.3390/ijms18071466
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author Mineo, Tommaso Claudio
Sellitri, Francesco
Vanni, Gianluca
Gallina, Filippo Tommaso
Ambrogi, Vincenzo
author_facet Mineo, Tommaso Claudio
Sellitri, Francesco
Vanni, Gianluca
Gallina, Filippo Tommaso
Ambrogi, Vincenzo
author_sort Mineo, Tommaso Claudio
collection PubMed
description 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.
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spelling pubmed-55359572017-08-04 Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy Mineo, Tommaso Claudio Sellitri, Francesco Vanni, Gianluca Gallina, Filippo Tommaso Ambrogi, Vincenzo Int J Mol Sci Article 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. MDPI 2017-07-07 /pmc/articles/PMC5535957/ /pubmed/28686211 http://dx.doi.org/10.3390/ijms18071466 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mineo, Tommaso Claudio
Sellitri, Francesco
Vanni, Gianluca
Gallina, Filippo Tommaso
Ambrogi, Vincenzo
Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title_full Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title_fullStr Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title_full_unstemmed Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title_short Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy
title_sort immunological and inflammatory impact of non-intubated lung metastasectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535957/
https://www.ncbi.nlm.nih.gov/pubmed/28686211
http://dx.doi.org/10.3390/ijms18071466
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