Immunologic and stress responses following video-assisted thoracic surgery and open pulmonary lobectomy in early stage lung cancer

Thorac Surg Clin. 2007 May;17(2):241-9, ix. doi: 10.1016/j.thorsurg.2007.04.001.


Conventional open major surgery evokes an injury response involving endocrine, neural, and immunologic mechanisms. The immunologic responses are characterized by release of cytokines, inflammatory mediators, and acute-phase proteins and by adverse disturbances in immune cell function. The use of a minimal access approach strategy is associated with a significant reduction in the cytokine response, as exemplified by reduced interleukin-6 levels and a corresponding reduction in acute-phase protein generation with reduced C-reactive protein levels. Circulating immune cell function and numbers also are better preserved. These changes have been demonstrated in comparing open with video-assisted thoracoscopic surgery (VATS) lobectomy and, together with further investigation into local immune function, may offer some insight into the excellent survival data reported for VATS resection of stage I non-small cell lung cancer.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Cytokines / metabolism
  • Humans
  • Immunity
  • Lung Neoplasms / immunology*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Neoplasm Staging
  • Pneumonectomy / adverse effects*
  • Pneumonectomy / methods
  • Stress, Physiological*
  • Thoracic Surgery, Video-Assisted / adverse effects*


  • Cytokines