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Chronic Neuralgia After Single-Port Versus Multiport Trans-Subxiphoid Robotic Mediastinal Surgery: A Prospective
Chuan Cheng1,2,3, Yu-Wen Wen3,4, Ming-Shan Chien3
1Division of Thoracic Surgery, New Taipei Municipal Tu-Cheng Hospital, New Taipei City, Taiwan.
Purpose:
To compare postoperative pain and chronic neuralgia between single-port (SP) and multiport (MP) trans-subxiphoid robotic approaches in patients with anterior mediastinum disease.
Methods:
In this prespecified secondary analysis of a prospective trial, we compared pain outcomes of patients undergoing SP trans-subxiphoid robotic surgery for anterior mediastinal disease with those of a historical MP cohort. Acute pain intensity was assessed using the Numeric Rating Scale (NRS) on postoperative days 0, 1 and 2, and at discharge. Chronic neuralgia at 6 months was evaluated with the PainDetect Questionnaire (PDQ).
Results:
Chronic neuralgia occurred in 6.7% (1/15) of the SP group versus 38.9% (7/18) of the MP group (p = 0.081). Most neuralgia cases in the MP group (6/7) involved multiple domains, whereas the single SP patient experienced only one symptom.
Conclusions:
SP trans-subxiphoid robotic surgery demonstrated comparable perioperative pain with significantly lower risk of chronic neuralgia.
Trial Registration:
This study represents a prespecified secondary analysis of a prospective clinical trial (ClinicalTrials.gov identifier: NCT05455840).
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