Consequences of persistent pain after lung cancer surgery: a nationwide questionnaire study

Wildgaard, Kim; Ravn, Jesper; Nikolajsen, Lone; Jakobsen, Erik; Jensen, Troels Staehelin; Kehlet, Henrik

doi:10.1111/j.1399-6576.2010.02357.x

Cited by 131 publications

(105 citation statements)

References 31 publications

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“…18 Dans les cas de thoracotomie ouverte, les lésions des nerfs intercostaux sont courantes et entraînent d'importantes conséquences en matière de douleur persistante. 19,20 Malgré les divers efforts déployés pour réduire les lésions nerveuses après l'écartement des côtes, aucun n'a eu d'impact significatif sur la douleur persistante. Par contre, la mise au point de la technique de résection pulmonaire assistée par vidéo (chirurgie thoracique) pourrait à l'avenir jouer un rôle important pour réduire la douleur persistante après une chirurgie thoracique, 20,21 étant donné que cette technique permet de ne pas trop écarter les côtes.…”

Section: Les Interventions Médicamenteuses Systémiquesunclassified

“…18 In open thoracotomy, it is well recognized that intercostal nerve injury is common with significant consequences of persistent pain. 19,20 Although various efforts have been made to reduce nerve injury following rib retraction, they have not had a meaningful impact on persistent pain. In contrast, the development of video-assisted lung resection (thoracic surgery) may play a future important role in the reduction of persistent pain after thoracic surgery, 20,21 as this technique avoids major rib retraction.…”

Section: Modified Surgical Techniquesmentioning

confidence: 99%

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Prevention of chronic pain after surgery: new insights for future research and patient care

Gilron

Kehlet

2013

Can J Anesth/J Can Anesth

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Section: Les Interventions Médicamenteuses Systémiquesunclassified

Section: Modified Surgical Techniquesmentioning

confidence: 99%

Prevention of chronic pain after surgery: new insights for future research and patient care

Gilron

Kehlet

2013

Can J Anesth/J Can Anesth

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“…There was pain reported in 25% of VATS patients and 33% of thoracotomy patients. There were no significant differences in comparisons of VATS to thoracotomy in regards to: prevalence, distribution of pain, sensory changes, and effect of pain on daily activities (18).…”

Section: Discussionmentioning

confidence: 81%

Prospective study of quality of life after lung cancer resection

Hopkins¹,

Ferson²,

Shende³

et al. 2017

Ann. Transl. Med.

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Background: Surgical resection with curative-intent remains the gold standard for clinically operable early-stage non-small cell lung cancer (NSCLC). This goal can be accomplished using a minimally invasive option, e.g., video assisted thoracic surgery (VATS) or standard thoracotomy. Surgical techniques continue to evolve and few studies have compared the QOL of patients managed with these procedures using current approaches. The primary goal of this study was to investigate differences between patients managed surgically via VATS compared to thoracotomy with respect to ratings of chronic pain, anxiety/depression and quality of life (QOL). The secondary goal was to investigate differences between patients converted from VATS to thoracotomy versus those managed with the originally with thoracotomy.Methods: We conducted a prospective cross sectional design study comparing the QOL after surgical resection of NSCLC. Data were obtained between 3-12 months postoperatively, from patients with potentially resectable stage I-IIIa NSCLC, who underwent a thoracotomy or VATS resection. All patients were consented. Pain was evaluated with a 0 to 10 numeric pain assessment scale (NAS), mood with the Hospital Anxiety and Depression Scale (HADS) (mood disorders) and QOL with FACT-L (Functional Assessment of Cancer Therapy-Lung).Results: A total of 97 patients with stage I-IIIa lung cancer were enrolled; of these 66 (68%) underwent a standard thoracotomy and 31 (32%) underwent VATS resection. The preferred surgical approach was a thoracotomy for patients with stage IIIa lung cancer, or patients requiring a pneumonectomy or a bi-lobectomy. There were no significant differences between VATS and thoracotomy patients in ratings of chronic pain, mood disorders, or QOL. Conversion from VATS to thoracotomy occurred in 22 (23%) of patients. There were no significant differences between VATS conversion to thoracotomy and those with initial thoracotomy procedures in ratings of chronic pain, mood disorders, or QOL. Conversion from VATS to standard thoracotomy occurred more commonly early in the series.Conclusions: While previous studies have shown that VATS offers an early advantage with regards to perioperative outcomes, our study demonstrated that VATS and thoracotomy patients had similar late QOL outcomes.

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“…This is evidenced by previous findings. In this regard, age, sex and other psychological or social factors have been shown to also play a significant role in postoperative chronic pain rates (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Impact of intercostal paravertebral neurectomy on post thoracotomy pain syndrome after thoracotomy in lung cancer patients: a randomized controlled trial

Koryllos¹,

Althaus²,

Poels³

et al. 2016

J. Thorac. Dis.

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Background: Thoracotomy leads to chronic neuropathic pain in up to 50% of patients and is responsible for an impaired quality of life. Intercostal nerve injury has been suggested to be responsible for this pain. In the present study the impact of paravertebral intercostal neurectomy on post thoracotomy pain was assessed.Methods: In this single center parallel-group randomized controlled trial patients underwent muscle sparing anterolateral thoracotomy and anatomical lung resection for lung cancer. A subcostal approach was used for thoracotomy with single paravertebral neurectomy being performed at the beginning of the procedure at the level of the retracted intercostal space. For documentation of neuropathic pain the Leeds Assessment Score for Neuropathic Symptoms and Signs (LANSS) was used postoperatively. The primary endpoint was defined as LANSS ≥12 points on day 120. In addition, the numeric pain rating scale (NRS) was used to score pain intensity.Results: Out of 172 patients initially randomized 161 patients were investigated following intraoperative and postoperative drop-out criteria. All patients required anatomical lung resection via thoracotomy. Five patients were lost for follow up. For the remaining 156 patients there was no difference between the two groups with regard to LANSS ≥12: 26.6 % in patients with neurectomy and 28.8% in control-subjects (P=0.78). In addition, the NSR score at day 120 did not differ significantly at rest and during activity between the two groups (at rest: 21.7% vs. 15.8% P=0.439; activity: 24.5% vs. 21.9% P=0.735). Conclusions:Neurectomy was not shown to reduce the post thoracotomy pain syndrome in patients with anatomical lung resection following anterolateral muscle sparing thoracotomy.

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Consequences of persistent pain after lung cancer surgery: a nationwide questionnaire study

Cited by 131 publications

References 31 publications

Prevention of chronic pain after surgery: new insights for future research and patient care

Prevention of chronic pain after surgery: new insights for future research and patient care

Prospective study of quality of life after lung cancer resection

Impact of intercostal paravertebral neurectomy on post thoracotomy pain syndrome after thoracotomy in lung cancer patients: a randomized controlled trial

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