Postoperative pain control: videothoracoscopic versus conservative mini-thoracotomic approach

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pain Management

Background:

• Postoperative pain management remains a challenge in thoracic surgery.
• Minimally invasive techniques are increasingly explored to improve patient outcomes.

Purpose of the Study:

• To compare postoperative pain and functional recovery between videothoracoscopic lobectomy and mini-thoracotomy for Stage I lung cancer.
• To evaluate the impact of surgical approach on patient recovery metrics.

Main Methods:

• A prospective, non-randomized study of 145 patients with Stage I lung cancer.
• Patients underwent either videothoracoscopic lobectomy (Group A, n=75) or mini-thoracotomy (Group B, n=70).
• Pain (visual analogue scale), spirometry, and six-minute walking test (6MWT) were assessed preoperatively, at 48 hours, and 1 month postoperatively.

Main Results:

• Videothoracoscopic approach (Group A) showed significantly lower postoperative pain scores at all measured time points (P = 0.000).
• Group A demonstrated better preservation of lung function (forced expiratory volume in 1 second) and superior 6MWT results at 48 hours and 1 month compared to Group B (P = 0.028 and P = 0.000, respectively).
• Hospital stay was shorter in Group A (median 4 days) versus Group B (median 6 days), though not statistically significant (P = 0.088).

Conclusions:

• The videothoracoscopic approach is associated with reduced postoperative pain after lobectomy for Stage I lung cancer.
• This minimally invasive technique facilitates faster functional recovery, including improved lung function and exercise capacity.
• Videothoracoscopic lobectomy offers a superior strategy for managing pain and enhancing recovery in selected lung cancer patients.