Critical appraisal:Zhang L, Ren Y, Liu Y 2015

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Critical Appraisal

Article being appraised

Zhang L, Ren Y, Liu Y. Comparison of the Effects of Lobectomy on Immunologic Function Between Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Non-Small-Cell Lung Cancer. Am J Ther 2015 Apr 23 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25909924.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Study aims:

To compare the effects of lobectomy on immunologic function between VATS and open surgery for non–small-cell lung cancer

Number of Patients:

80

Reported outcome(s):

Operative blood loss and transfusion volume
C-reactive protein (CRP), serum amyloid A (SAA), interleukin (IL) 6, and interleukin 2 receptor (IL-2R) were detected before operation, 24 hours, and 72 hours after operation
Peripheral blood lymphocytes, proportion of CD4+ T lymphocytes, CD8+ T lymphocytes, and natural killer (NK) in lymphocytes detected before operation, 3 days, and 7 days after operation
FACT-Lung (FACT-L) questionnaire before operation and 6 months after operation

Results of outcome(s):

Blood loss and transfusion volume during operation in VATS group were less than open group (p< 0.05)
Serum amyloid A levels 12 hours after operation in open group were higher than those in VATS group (p< 0.05)
Preoperative and postoperative levels of CPR, IL-6, and IL-2R showed difference between open and VATS group.
Preoperative and postoperative proportions of CD4+ T lymphocytes and NK in lymphocytes and the number of lymphocytes were no different between VATS and open groups.
Proportion of CD8+ T-lymphocytes 7 days after operation in open group was clearly lower than that in VATS group (p< 0.05)
Postoperative physiologic and functional conditions in VATS were better than those in open group (p< 0.05)

Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Low risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?
I am reasonably certain that the trial was double-blinded (eg identical placebo, active placebo, double-dummy, no revealing side-effects).
Was the treatment allocation schedule concealed?
Adequately concealed (e.g. central randomisation, numbered or coded bottles, drugs prepared by pharmacy).
Were all randomised participants included in the analysis?
No exclusions or survival analysis used with all subjects included (>95% follow-up for all groups).
The field below is not considered when calculating the risk of bias rating
How was the allocation schedule generated?
Inadequate or not reported
Size of effect
1 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
1 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

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Completed by

Associate Professor Gavin Wright MD FRACS PhD


Jutta's tick icon.png This appraisal has been completed.


Article
Zhang L, Ren Y, Liu Y. Comparison of the Effects of Lobectomy on Immunologic Function Between Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Non-Small-Cell Lung Cancer. Am J Ther 2015 Apr 23 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25909924.
Assigned to
User:Gavin.wright
Topic area
Guidelines:Lung cancer/Treatment/Non-small-cell stage I operable
Clinical question
Form
Form:Critical appraisal


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