Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints


ID Serval
Article: article d'un périodique ou d'un magazine.
Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints
European Journal of Cardio-Thoracic Surgery
Furrer  M., Rechsteiner  R., Eigenmann  V., Signer  C., Althaus  U., Ris  H. B.
1010-7940 (Print)
Statut éditorial
Date de publication
Comparative Study
Journal Article --- Old url value: --- Old month value: Jul
OBJECTIVE: Two different surgical accesses combined with standard pain management procedures are compared regarding early and intermediate pulmonary function and pain relief. METHODS: In a prospective study, 15 consecutive patients undergoing video-thoracoscopy for pulmonary wedge resection (group 1) were matched to 15 patients undergoing standard postero-lateral thoracotomy for lobectomy (group 2) according to age, gender and preoperative pulmonary function. Postoperative pain control consisted of patient controlled analgesia in group 1 and epidural analgesia in group 2. Pain intensity was scored from 0-4. The predicted postoperative pulmonary function (FVC and FEV 1) after lobectomies was calculated from the preoperative value according to the extent of resection. A clinical measurement was obtained after a mean follow-up time of 4.2 months. RESULTS: The ratios of postoperative measured to predicted values of FVC and FEV1 for group 1 compared with group 2 were 0.64 +/- 0.15 and 0.65 +/- 0.14 compared with 0.60 +/- 0.19 and 0.59 +/- 0.13, resp. (both n.s.) at the first day postoperative; 0.92 +/- 0.18 and 0.95 /- 0.17 compared with 0.76 +/- 0.20 (P < 0.05) and 0.83 +/- 0.23 (n.s.), resp. at hospital discharge; 0.98 +/- 0.10 and 0.94 +/- 0.14 compared with 1.01 +/- 0.17 (n.s.) and 1.10 +/- 0.17 (P < 0.05), resp. at follow-up. Pain intensity score one day after surgery ranged from 0.4 (resting position) to 1.6 (coughing) for group 1, and from 0.3 to 1.2 for group 2. Thirty-six percent of the thoracoscopy patients and 33% of the thoracotomy group complained of persistent pain or discomfort on the site of the operation after 3-18 months. CONCLUSION: Post-thoracotomy pain can be effectively controlled with epidural analgesia and pain intensity is no higher than in patients after thoracoscopy who are managed with patient controlled analgesia. FVC is slightly more decreased after thoracotomy during the early postoperative period. FVC and FEV 1 approach the predicted values after four months in both groups. The rate of persistent pain is similar after thoracoscopy and thoracotomy.
Adult Aged Analgesia, Epidural Analgesia, Patient-Controlled Female Forced Expiratory Volume Humans Male Middle Aged Pain, Postoperative/*etiology Pneumonectomy/*methods Prospective Studies *Respiratory Mechanics *Thoracoscopy *Thoracotomy Vital Capacity
Web of science
Création de la notice
29/01/2008 14:00
Dernière modification de la notice
03/03/2018 18:37
Données d'usage