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Limited thoracotomy for segmentectomy: a comparison of postoperative pain with thoracoscopic lobectomy

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Abstract

Purposes

To assess whether a video-assisted thoracoscopic surgery (VATS) procedure is superior to limited thoracotomy (LT) for segmentectomy; postoperative pain was compared between VATS-lobectomy (VATS-L) and LT-segmentectomy (LT-S). Widely opened anterolateral thoracotomy segmentectomy (WT-S) was used as a control.

Methods

This study was a retrospective analysis of prospectively collected data for 220 consecutive patients with stage I NSCLC treated between 2012 and 2015 at a single institute using VATS-L (n = 58), LT-S (n = 93), or WT-S (n = 69). Pain scores from postoperative days (POD) 1–4 were measured using a visual analog scale three times a day. Chronic pain was assessed by the need for analgesics at 1, 2, and 3 months postoperatively.

Results

No significant differences in pain from POD 1 to 4 were observed between VATS-L and LT-S, whereas WT-S showed significantly higher pain scores than these two procedures (p = 0.0001–0.02). Chronic pain did not differ significantly among the procedures.

Conclusion

Postoperative pain does not differ significantly between VATS-L and LT-S. LT may be preferable to VATS for segmentectomy to identify the anatomy, dissect the hilar nodes, and establish surgical margins.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Chiba, Kamogawa city, 296-8602, Japan

    Hiroaki Nomori, Yue Cong & Hiroshi Sugimura

Authors
  1. Hiroaki Nomori
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  2. Yue Cong
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  3. Hiroshi Sugimura
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Corresponding author

Correspondence to Hiroaki Nomori.

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The authors have no conflicts of interests or financial ties to disclose.

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Nomori, H., Cong, Y. & Sugimura, H. Limited thoracotomy for segmentectomy: a comparison of postoperative pain with thoracoscopic lobectomy. Surg Today 46, 1243–1248 (2016). https://doi.org/10.1007/s00595-015-1302-4

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  • DOI: https://doi.org/10.1007/s00595-015-1302-4

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