scholarly journals Improving postoperative pain management after video-assisted thoracic surgery lung resection contributes to enhanced recovery, but guidelines are still lacking

2018 ◽  
Vol 10 (S9) ◽  
pp. S983-S987 ◽  
Author(s):  
Marco Mercieri ◽  
Antonio D’Andrilli ◽  
Roberto Arcioni
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Enhanced Recovery ◽  
Lung Resection ◽  
Postoperative Pain Management ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

scholarly journals Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Benoît Bédat ◽  
Etienne Abdelnour-Berchtold ◽  
Thomas Perneger ◽  
Marc-Joseph Licker ◽  
Alexandra Stefani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Benign Lesion ◽  
Lung Resection ◽  
Primary Lung Cancer ◽  
Forced Expiratory Volume ◽  
University Hospitals ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Abstract Background Compared to lobectomy by video-assisted thoracic surgery (VATS), segmentectomy by VATS has a potential higher risk of postoperative atelectasis and air leakage. We compared postoperative complications between these two procedures, and analyzed their risk factors. Methods We reviewed the records of all patients who underwent anatomical pulmonary resections by VATS from January 2014 to March 2018 in two Swiss university hospitals. All complications were reported. A logistic regression model was used to compare the risks of complications for the two interventions. Adjustment for patient characteristics was performed using a propensity score, and by including risk factors separately. Results Among 690 patients reviewed, the major indication for lung resection was primary lung cancer (86.4%) followed by metastasis resection (5.8%), benign lesion (3.9%), infection (3.2%) and emphysema (0.7%). Postoperatively, there were 80 instances (33.3%) of complications in 240 segmentectomies, and 171 instances (38.0%) of complications in 450 lobectomies (P = 0.73). After adjustment for the patient’s propensity to be treated by segmentectomy rather than lobectomy, the risks of a complication remained comparable for the two techniques (odds ratio for segmentectomy 0.91 (0.61–1.30), p = 0.59). Length of hospital stay and drainage duration were shorter after segmentectomy. On multivariate analysis, an American Society of Anesthesiologists score above 2 and a forced expiratory volume in one second below 80% of predicted value were significantly associated with the occurrence of complications. Conclusions The rate of complications and their grade were similar between segmentectomy and lobectomy by VATS.

Effect of Epidural Magnesium on the Incidence of Chronic Postoperative Pain After Video-Assisted Thoracic Surgery

2012 ◽  
Vol 26 (6) ◽  
pp. 1055-1059 ◽  
Author(s):  
Joon-Ho Lee ◽  
Woo-Dae Yang ◽  
Seong-Yeup Han ◽  
Jeong-Il Noh ◽  
Seong-Hwan Cho ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Chronic Postoperative Pain ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

scholarly journals Uni-portal and three-portal video-assisted thoracic surgery pulmonary lobectomy for early stage lung cancer (UNIT trial): study protocol of a single-center randomized trial

2021 ◽  
Author(s):  
Paolo Mendogni ◽  
Alessandra Mazzucco ◽  
Alessandro Palleschi ◽  
Lorenzo Rosso ◽  
Ilaria Righi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Early Stage ◽  
Pulmonary Lobectomy ◽  
Analgesic Drug ◽  
Early Stage Lung Cancer ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Stage Lung Cancer

Abstract BackgroundVideo-assisted thoracoscopic surgery (VATS) lobectomy is currently the recommended approach for treating early-stage non-small cell lung cancer (NSCLC). Different VATS approaches have been proposed so far, and the actual advantages of one technique over the other are still under debate. The aim of our study is to compare postoperative pain and analgesic drug consumption in uniportal VATS and triportal VATS for pulmonary lobectomy in early-stage lung cancer patients. MethodsThis study is a single-centre, prospective, two-arm, parallel-group, randomized controlled trial. It is designed to compare uniportal video-assisted thoracic surgery (u-VATS) and three-ports video-assisted thoracic surgery (t-VATS) in terms of post-operative pain. The trial will enrol 120 patients with a 1:1 randomization. The primary outcome is the assessment of analgesic drug consumption. Secondary outcomes are postoperative pain measurement, evaluation of postoperative pulmonary function, and metabolic recovery after pulmonary lobectomy. DiscussionThe choice of which VATS approach to adopt for treating patients undergoing pulmonary resection mostly depends on the surgeon’s preferences; therefore, it is hard to prove whether one VATS technique is superior to the other. Moreover, postoperative analgesic protocols vary consistently among different centres. To date, only a few studies have evaluated the effects of the most popular VATS techniques. There is no evidence about difference between multi-ports VATS and u-VATS in terms of postoperative pain. We hope that the results of our trial will provide valuable information on the outcomes of these different surgical approaches.Trial registrationClinicalTrials.gov. NCT03240250; registered 08/07/2017; retrospectively registered; https://clinicaltrials.gov/ct2/show/NCT03240250?term=NCT03240250&draw=2&rank=1

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