title: Limited thoracotomy for segmentectomy: a comparison of postoperative pain with thoracoscopic lobectomy.
abstract: OBJECTIVE
  To assess whether a video-assisted thoracoscopic surgery (VATS) procedure is superior to limited thoracotomy (LT) for segmentectomy; postoperative pain was compared between VATS-lobectomy (VATS-L) and LT-segmentectomy (LT-S). Widely opened anterolateral thoracotomy segmentectomy (WT-S) was used as a control.
  
  
  METHODS
  This study was a retrospective analysis of prospectively collected data for 220 consecutive patients with stage I NSCLC treated between 2012 and 2015 at a single institute using VATS-L (n = 58), LT-S (n = 93), or WT-S (n = 69). Pain scores from postoperative days (POD) 1-4 were measured using a visual analog scale three times a day. Chronic pain was assessed by the need for analgesics at 1, 2, and 3 months postoperatively.
  
  
  RESULTS
  No significant differences in pain from POD 1 to 4 were observed between VATS-L and LT-S, whereas WT-S showed significantly higher pain scores than these two procedures (p = 0.0001-0.02). Chronic pain did not differ significantly among the procedures.
  
  
  CONCLUSIONS
  Postoperative pain does not differ significantly between VATS-L and LT-S. LT may be preferable to VATS for segmentectomy to identify the anatomy, dissect the hilar nodes, and establish surgical margins.
authors.affiliation: Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Chiba, Kamogawa city, 296-8602, Japan. hnomori@qk9.so-net.ne.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
authors.affiliation: Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Chiba, Kamogawa city, 296-8602, Japan.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cong
authors.affiliation: Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Chiba, Kamogawa city, 296-8602, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D008168:Lung / Q000033:anatomy & histology; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*
keywords: Lung cancer; Open thoracotomy; Pain; Segmentectomy; Thoracoscopic surgery