Incidence of chronic pain after minimal-invasive surgery for spontaneous pneumothorax
Incidence of chronic pain after minimal-invasive surgery for spontaneous pneumothorax
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DOI：
10.1016/s1010-7940(01)00568-1
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发表时间：
2001-03-01
影响因子：
3.4
通讯作者：
Thetter, O
中科院分区：
文献类型：
--
作者：
Passlick, B;Born, C;Thetter, O
目的：最近有研究表明，像自发性气胸手术这样的微创手术可以减少术后即刻的疼痛。然而，关于微创胸部手术对长期残疾的影响，我们知之甚少。因此，我们分析了原发性(PSP)和继发性(SSP)自发性气胸微创手术后慢性疼痛的发生率。方法：选择1992年至1995年收治的78例PSP患者，其中PSP患者59例，SSP患者19例，男性58例，女性20例。中位年龄37岁(范围17-84岁)。患者通过标准化问卷进行采访，或者通过电话或在门诊进行采访。从60例患者中获得了完整的随访数据，并进行了进一步分析。结果：中位随访59个月(范围35-79个月)，41例(68.3%)患者完全无主诉。但有19例(31.7%)患者存在慢性疼痛。其中两人(3.3%)需要每天服用口腔止痛药。接受胸膜切除术的患者慢性主诉发生率(47.1%)高于单纯机械胸膜固定术患者(25.6%；P=0.107)。在视觉模拟疼痛评分(从0到100)中，5例(8.3%)患者的疼痛强度为10，12例(20%)患者的疼痛强度在10到20之间，2例患者(3.3%)的疼痛强度为50。在大多数患者中，疼痛位于套管针切口处。6例(10%)患者有同侧肩关节的慢性主诉。结论：自发性气胸微创手术后慢性主诉发生率较高。如果讨论将微创手术作为治疗首发自发性气胸的简单引流疗法的替代方案，则必须考虑这一点。(C)2001 Elsevier Science B.V.保留所有权利。
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. (C) 2001 Elsevier Science B.V. All rights reserved.