To investigate the effect of thoracotomy on pulmonary surfactant(PS) in moderate high altitude localities.

Twenty-one patients with esophageal carcinoma undergoing thoracotomy on the left between September 2013 and April 2015 in Department of Thoracic Surgery in Qinhai Provincial People’s Hospital were enrolled. Bilateral broneho-alveolar lavage was carried out before and after operation. The indicators including saturated phosphati-dylcholine (SatPC), total protein(TP) and total phospholipid(TPL) in broneho-alveolar lavage fluid (BALF) were measured. The corresponding indicators in the right side were served as controls, and SatPC/TPL and SatPC/TP as indicators of activity of PS in BALF.

Before operation, the values of SatPC/TPL in BALF were (48.75±14.39)% and (48.76±12.90)% in the left side and right side, respectively, and those were (10.88±2.24)% and (11.78±2.24)%, respectively for SatPC/TP in BALF, with no significant difference in these two indicators between two sides(t=-0.0024, P>0.05; t=-1.3019, P>0.05). After operation, the value of SatPC/TPL in BALF in the left side was significantly smaller than that in the right side [(26.15±9.81)% vs (47.62±12.58)%, t=6.1674, P<0.01], and the value of SatPC/TP in BALF in the left side was also significantly smaller than that in the right side [(5.34±2.54)% vs (10.15±2.28)%, t=6.4579, P<0.01]. The value of SatPC/TPL in BALF after operation was significantly smaller than that before operation in the left side[ (26.15±9.81)% vs (48.75±14.39)%, t=5.9467, P<0.01], and the value of SatPC/TP in BALF after operation was also significantly smaller than that before operation in the left side[ (5.34±2.54)% vs (10.88±2.24)%, t=7.4964, P<0.01]. The value of SatPC/TPL in BALF after operation was not significantly different from that before operation in the right side[ (47.62±12.58)% vs (48.76±12.90)%, t=0.2889, P>0.05], and the value of SatPC/TP in BALF after operation was also not significantly smaller than that before operation in right left side [ (10.15±2.28)% vs (11.78±2.24)%, t=2.3370, P>0.05].

In the moderate high altitude localities, thoracotomy may induce lung injury and decrease the activity of PS in the operation side, while it may not cause injury in the non-operation side.