Sequels 10 years after thoracoscopic procedures for benign disease.
OBJECTIVE
Video-assisted thoracic surgery (VATS) is recognized to be as effective as open thoracic surgery for a variety of diagnostic and therapeutic conditions, but with significantly less morbidity. Chronic postoperative pain (CPP) is defined as persisting more than 2 months after the procedure. CPP and other neurological sensations like dysesthesia or numbness are found frequently, but little is known about the outcome of those patients many years after the primary procedure.


METHODS
In 1999 we retrospectively investigated a group of 46 (31.9%) out of 144 patients who were identified with sequels at a mean of 32 months after a VATS procedure. Now at 123 months postoperation we reinvestigated those patients for ongoing sequels.


RESULTS
Out of 46 patients, 36 were still alive and could be reached for an interview. Eighteen patients (50%) were now free from symptoms while 18 patients (50%) still suffered from sequels. From the group of 144 patients operated on, sequels were now present in 18 patients (12.5% at 123 months vs 31.4% at 32 months, p=0.0002). Pain was present in 17 patients (11.8% vs 20.1%, p=0.11), in 3 patients (2.1% vs 18.1%, p<0.000001) even at rest, and in 4 patients (2.7% vs 12.5%, p=0.0002) only at exercise. Ten patients (6.9% vs 28.5%, p=0.096) suffered from pain occasionally, e.g. because of changing weather. Painkillers were taken only by one patient (0.7% vs 16.6%, p<0.0001) occasionally, and the sequels impacted the life of one female patient (0.7% vs 13.2%, p<0.0001) badly. Numbness was present in 16.9% versus 1.3% (p=0.0013) of patients.


CONCLUSIONS
Early postoperative sequels are frequently found in VATS procedures, but patients with pain even after years have a nearly 50% chance to eliminate their problems. In addition, numbness and dysesthesia seem to disappear almost completely several years after the procedure.
Hutter
Jörg
J
Department of Surgery, Paracelsus Private Medical University, Müllnerhauptstr 48, 5020 Salzburg, Austria. j.hutter@salk.at
Reich-Weinberger
Silvia
S
Hitzl
Wolfgang
W
Stein
Hubert J
HJ
D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain; D012189:Retrospective Studies; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D013906:Thoracoscopy / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects*; D016896:Treatment Outcome