[Long-term complaints after minimal invasive thoracic surgery operations and thoracotomy].
BACKGROUND
Minimally invasive techniques are now frequently used in general thoracic surgery. More than 30% of all minimally invasive procedures are operations in patients with spontaneous pneumothorax. Recently, it has been shown that the video-assisted approach compared to the standard anterolateral thoracotomy results in a significant reduction of the early postoperative pain. However, little is known about the influence of video-assisted surgery on long-term complaints.


METHODS
We analyzed the frequency and characteristics of chronic complaints in 60 patients after video-assisted operations for spontaneous pneumothorax using a standardized questionnaire. For comparison, 27 patients after anterolateral thoracotomy for benign diseases were interviewed 24 months postoperatively using the same questionnaire.


RESULTS
After minimally invasive surgery and a median observation time of 59 months, 19 (31.7%) out of 60 patients suffered from chronic complaints. Two of them (3.3%) required daily oral pain medication. On a visual analog pain scale (ranging from 0 to 100), 17 patients described a pain intensity of < 20 and 2 (3.3%) patients > 50. After thoracotomy 14 (51.8%) out of 27 patients suffered from chronic complaints, 5 (18.5%) of them with regular use of oral pain medications. The mean pain intensity (analog scale) was 3.6 points after minimally invasive operations and 14.4 points after thoracotomy (P = 0.01).


CONCLUSIONS
In conclusion, even after minimally invasive thoracic operations some patients suffer from chronic complaints. However, they are less frequent and of lower intensity than after thoracotomy.
Passlick
B
B
Klinik für Thoraxchirurgie, Asklepios Fachkliniken München-Gauting. Passlick@LRZ.uni-muenchen.de
Born
C
C
Mandelkow
H
H
Sienel
W
W
Thetter
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010043:Outcome and Process Assessment, Health Care; D010149:Postoperative Pain / Q000209:etiology; D011030:Pneumothorax / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy