Lymphocyte responses following open and minimally invasive thoracic surgery

Background Immunosuppression associated with surgery may predispose to incr eased tumour growth or recurrence. Lymphocytes are central components of th e immune network, signalling specific and non-specific responses in tumour immunosurveillance, This study was therefore designed to compare the effect s of minimally invasive and conventional approaches to major thoracic surge ry on lymphocyte populations and oxidative activity Patients and methods The effects of conventional and minimally invasive vid eo-assisted thoracic:surgery (VATS) on the numbers and types of circulating lymphocytes and an lymphocyte oxidation were compared in a prospective ran domized study of 41 patients undergoing lobectomy for peripheral bronchogen ic carcinoma. Blood taken pre-operatively and on days 2 and. 7 post-operati vely was analysed for T (CD4, CD8), B (CD19) and natural killer (NK) (CD56, CD16) cell counts and for lymphocyte oxidative activity. Leucocyte numbers were compared with pre-surgical values and oxidative: rate with healthy do nor controls. Results Lymphocyte counts fell after surgery; VATS was associated with less effect on circulating T (CD4) cells at 2 days and on NK lymphocytes at 7 d ays post-surgery. Lymphocyte oxidation was less suppressed in the VATS grou p 2 days after surgery, In general, post-surgical changes in keg cells of c ellular immunity were smaller in the VATS group, and recovery to normal lev els was more rapid. Conclusion The degree of invasiveness of thoracic surgery may influence the extent of immunosuppression in patients undergoing pulmonary lobectomy for pulmonary neoplasm.