胸腔镜与开胸肺叶切除治疗非小细胞肺癌对机体免疫功能影响的研究进展

电视辅助胸腔镜手术（video-assisted thoracoscopic surgery，VATS）是胸部微创手术的代表，已被广泛应用于胸部疾病的诊断和治疗，特别是早期肺癌的治疗。VATS具有创伤小、疼痛轻、恢复快、住院时间短以及并发症少等优势，也有研究指出，胸腔镜肺叶切除治疗早期非小细胞肺癌术后长期存活率不亚于传统开胸手术。国内外许多研究者对比了VATS及开胸手术对机体免疫功能影响的差异，一致认为VATS手术能更好地保护术后机体的免疫功能，更有利于术后机体的恢复，以此作为胸腔镜发挥其微创优势的机制之一。本文从细胞因子、免疫细胞数目、免疫细胞功能等方面出发，将国内外近几年研究VATS肺叶切除手术治疗非小细胞肺癌对机体免疫功能影响的文献加以综述。 

Postoperative Immune Functions after Video-Assisted Thoracoscopic Surgery and Thoracotomic Lobectomy for Non-Small Cell Lung Cancer Treatment

Video-assisted thoracoscopic surgery (VATS) is one of the most important minimally invasive procedures in the field of thoracic surgery. VATS is now widely used in the diagnosis and treatment of thoracic diseases, especially lung cancers, given its many advantages over traditional thoracotomy. These advantages include minimal invasion, reduced postoperative pain, quicker recovery, shorter hospital stay, and less complication. Some recent studies also indicate that following VATS lobectomy, the long-term survival rate of patients with non-small cell lung cancer is similar to that after conventional surgery. Numerous researchers have also compared immune functions after VATS and thoracotomy. They reveal that VATS can better preserve the immune functions of the body, which benefits the recovery of patients and decreases the opportunity of recurrence. Thus, immune function preservation may be one of the mechanisms of the minimal invasiveness of VATS. This paper reviews reports over the past few years that discuss the effect of VATS on immune functions. The following aspects are given focus: cytokines as well as the number and function of immune cells.