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Video-assisted thoracic surgery (VATS) shows a lower incidence of persistent postsurgical pain (PPP) and functional impairment compared to thoracotomy. However, some patients still experience pain-related limitations after VATS.

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Area of Science:

  • Thoracic Surgery
  • Pain Management
  • Surgical Outcomes

Background:

  • Persistent postsurgical pain (PPP) and functional impairment are significant concerns after thoracic surgery.
  • Video-assisted thoracic surgery (VATS) may offer a reduced risk of PPP compared to traditional thoracotomy.

Purpose of the Study:

  • To evaluate the incidence and impact of PPP on daily activities following VATS.
  • To compare PPP incidence after VATS with historical data from thoracotomy.

Main Methods:

  • Prospective observational study of 47 patients undergoing VATS.
  • Data collected preoperatively, early postoperatively, and at 3-month follow-up.
  • Assessed pain, psychological factors, functional impairment, and quantitative sensory testing (QST).

Main Results:

  • 11% of patients developed PPP (NRS > 3) from the surgical site.
  • Approximately 30% reported functional impairment in daily activities.
  • Preoperative pin-prick sensitivity was the only predictor of PPP; psychological factors did not predict PPP.

Conclusions:

  • VATS demonstrated a lower incidence of PPP, nerve damage, and functional impairment than thoracotomy.
  • No psychological or other preoperative factors predicted PPP after VATS.
  • Further large-scale studies are warranted to confirm VATS's benefit in reducing PPP.