Association Of Chronic Post-surgical Pain After Single-port And Three-port Video-assisted Thoracic Lung Resection

OBJECTIVE: To analyze the incidence and related factors of chronic post-surgical pain after single-port and three-port Video-assisted thoracic partial lung resection.METHODS: Patients undergone either single-port or three-port VATS partial lung resection from August,2015 to August,2016 in Fujian Medical University Union Hospital were included in this study.In January 2017,contact was obtained with each patient and informed consent was achieved orally through telephone,following-up by a questionnaire concerning patient's general data(age,sex,operative name,the occurrence of chronic post-surgical pain(CPSP),the degree of pain assessed by numerical rating scale(NRS),neuropathic pain composition of pain evaluated by Douleur Neuropathique 4 Questions(DN4)and the impact of psychological status estimated by Hospital Anxiety and Depression Scale(HADS).The data of those patients was collected and analyzed,including height,weight,history of smoking,alcohol intake,hypertension and diabetes mellitus,ASA classification,operative duration,pathologic type,chemotherapy,duration of drainage tube.RESULTS: Finally a total of 157 cases completed the study of all investigations,excluding 46 cases without informed consent,69 failing to contact,63 unfinishing the questionare and 9 containing incomplete data.The total incidence of CPSP was 32.5%.The incidence of CPSP in the three-port group(43.1%)was higher than that in the single-port group(23.5%)(P=0.009).Among the patients with chronic post-surgical pain,no statistical significance differences was revealed between single-port and three-port group in NRS score(2.5 + 1.1 and 2.9 + 1.1),proportion of mild pain(85% and 80.6%),proportion of neuropathic pain(20% and 26%),the incidence of postoperative anxiety(35% both)and the incidence of postoperative depression(5% and 0%)(P=0.122,0.690,0.633,0.972 and 0.209).ASA classification was risk factor of CPSP with multivariate logistic regression model(OR= 7.015,P=0.005).CONCLUSION: The incidence of chronic post-surgical pain after three-port VATS partial lung resection was higher than that of single-port and most of the patients with CPSP were mild pain.Both procedures had the similar effect on the post-surgical psychological status in CPSP.ASA classification was an influencing factor of CPSP undergoing VATS partial lung resection.