title: Subcostal closure technique for prevention of postthoracotomy pain syndrome.
abstract: BACKGROUND
  The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome.
  
  
  METHODS
  From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group). The duration of oral opioid consumption was evaluated from medical records, and postoperative pain was evaluated by telephone interview conducted by a trained nurse practitioner who was unaware of the patient's group.
  
  
  RESULTS
  Pain scores were higher in the thoracoscopy group compared to the subcostal closure group, reaching statistical significance (Numeric Rating Scale 0.55 ± 0.948 in the subcostal closure group vs. 1.84 ± 1.614 in the thoracoscopy group; p < 0.001, Clinical Pain Scale 0.24 ± 0.435 in the subcostal closure group vs. 0.81 ± 0.703 in the thoracoscopy group; p < 0.001). The number of patients who consumed oral opioids for longer than 2 months after the operation was significantly greater in the thoracoscopy group than the subcostal closure group (6.9% in the subcostal closure group vs. 32.3% in the thoracoscopy group; p = 0.022).
  
  
  CONCLUSIONS
  The subcostal closure technique is useful to prevent postthoracotomy pain syndrome.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea kipyoh@yahoo.co.kr.
authors.forename: Kipyo
authors.initials: K
authors.lastname: Hong
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea.
authors.forename: Mikyung
authors.initials: M
authors.lastname: Bae
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea.
authors.forename: Sora
authors.initials: S
authors.lastname: Han
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011013:Pneumonectomy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D058106:Wound Closure Techniques
chemical_list: D000701:Analgesics, Opioid
keywords: Intercostal nerves; Pain; Pain measurement; Suture techniques; Thoracic surgery; Thoracotomy; postoperative; video-assisted