Original articleGeneral thoracicImpact of Awake Videothoracoscopic Surgery on Postoperative Lymphocyte Responses
Section snippets
Study Design and Randomization Procedure
The investigation was set up as a prospective randomized two-arm study (awake group versus control general-anesthesia group). The study was approved by the Ethical Committee of the Policlinico Tor Vergata Foundation. Mandatory prerequisite for enrollment was considered the diagnosis of a nonmalignant chest disease scheduled for VATS. Other inclusion criteria are detailed in Table 1.
The study was activated in October 2008 and was closed in June 2009 after the achievement of 50 patients. Prior to
Baseline Data and Surgical Results
Out of the 59 patients initially considered for enrollment, 3 patients refused consent because they preferred general anesthesia. After randomization, 6 patients (3 for each group) were excluded because of conversion to thoracotomy under general anesthesia (n = 2), diagnosis of unexpected malignant nodules (n = 2), postoperative air leakage longer than 7 days (n = 1), and severe ventricular arrhythmia requiring electric conversion in the immediate postoperative period (n = 1). As a consequence
Comment
Preserved lymphocyte function contributes to improve resistance to postoperative infections [4, 5, 6].
In addition, natural-killer cells represent a possible first line of defense against intravascular tumor spread because, in absence of major histocompatibility-complex restriction, different types of malignant cells can be killed by these cells in a nonspecific way [5, 9, 11, 12, 13]. Furthermore, an impairment in immune function and lymphocyte activity has shown to be associated with several
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