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Eur J Cardiothorac Surg 2001;19:355-359
© 2001 Elsevier Science NL
a Department of Surgery, University of Munich, Munich, Germany
b Department of Thoracic Surgery, Asklepios Fachklinik Munich-Gauting, Munich, Germany
Received 3 August 2000; received in revised form 19 November 2000; accepted 27 November 2000.
Corresponding author. Department of Surgery, Klinikum Innenstadt, Ludwig-Maximilians-University, Nußbaumstrasse 20, D-80336 Munich, Germany. Tel.: +49-89-85791-7333; fax: +49-89-85791-7335
e-mail: passlick{at}lrz.uni-muenchen.de
Objective: Recently, it has been shown that minimal-invasive surgical procedures like operations for spontaneous pneumothorax result in a reduction of pain in the immediate postoperative course. However, little is known on the influence of minimal-invasive thoracic surgery on long term disability. Therefore, we analyzed the incidence of chronic pain in patients after minimal-invasive operation for primary (PSP) or secondary (SSP) spontaneous pneumothorax. Methods: In the study included were 78 patients (PSP: n=59; SSP: n=19; male: 58, female 20) who had been treated at our institution between 1992 and 1995. The median age was 37 years (range: 17–84). The patients were interviewed by a standardized questionnaire or alternatively by phone or in the outpatient clinic. Complete follow up data were obtained from 60 patients which were further analyzed. Results: After a median follow up of 59 months (range 35–79) 41 (68.3%) patients were completely free from any complaints. However 19 (31.7%) patients suffered from chronic pain. Two of them (3.3%) required daily oral pain medication. The incidence of chronic complaints was more frequent in patients with pleurectomy (47.1%) as compared to patients with mechanical pleurodesis only (25.6%; P=0.107). On a visual analog pain scale (ranging from 0 to 100) five (8.3%) patients described a pain intensity <10, 12 (20%) patients between 10 and 20 and two (3.3%) patients >50. In the majority of the patients the pain was located in the area of the trocar incisions. Six (10%) patients had a chronic complaints in the ipsilateral shoulder. Conclusions: The incidence of chronic postoperative complaints after minimal-invasive procedures for spontaneous pneumothorax is relatively high. This has to be considered if minimal-invasive procedures are discussed to be an alternative to simple drainage therapy for the first episode of spontaneous pneumothorax.
Key Words: Postoperative pain • Spontaneous pneumothorax • Minimal-invasive techniques • Video-assisted thoracic surgery
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