Comparison of Postoperative Quality of Life and Pain with and without a Metal Rib Spreader in Patients Undergoing Lobectomy through Axillary Mini-Thoracotomy for Stage I Lung Cancer

Ichimura, Hideo; Kobayashi, Keisuke; Gosho, Masahiko; Nakaoka, Kojiro; Yanagihara, Takahiro; Saeki, Yusuke; Satô, Yukio

doi:10.5761/atcs.oa.21-00148

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…The EQ5D is a preference-based measure and has been used to measure health utility as the EQ5D index value for the economic evaluation of healthcare outcomes. As we reported previously ( 11 , 12 ), the EQ5D has some advantages for evaluating patients’ QOL in perioperative settings. Namely, it requires only 2 min to answer and has no recall period (<24 h), which enables us to administer the EQ5D every other day during a patient’s hospitalization.…”

Section: Discussionmentioning

confidence: 73%

Comparison of patient-reported outcomes and clinical outcomes between pleurectomy and pleural covering added to thoracoscopic bullectomy for primary spontaneous pneumothorax

Kobayashi¹,

Ichimura²,

Kawabata³

et al. 2023

J Thorac Dis

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Background An optimal surgical procedure for primary spontaneous pneumothorax (PSP) has not yet been established. The study aimed to compare patient-reported outcomes (PROs) and clinical outcomes between parietal pleurectomy (pleurectomy) and visceral pleural covering with absorbable prosthesis (covering) added to thoracoscopic bullectomy in patients with PSP. Methods From January 2015 to April 2018, PROs were prospectively evaluated using EuroQOL-5 dimensions-5 levels (EQ5D). Questionnaires were administered preoperatively and at 1, 3, and 5 days and 1 month postoperatively. The perioperative outcomes were compared retrospectively. Recurrences and postoperative symptoms in the distant period were investigated cross-sectionally by telephone and mail surveys in February 2020. Results In total, 26 and 29 patients underwent covering and pleurectomy, respectively. The visual analog scale score of the EQ5D on postoperative day 1 was significantly better in the pleurectomy group than in the covering group. There was no significant difference in the frequency of PROs in the EQ5D including pain. Perioperative outcomes, such as postoperative chest tube placement, and hospital stay, were comparable between the groups, except for the operative time. There was no significant difference in the recurrence rate and frequency of residual symptoms, e.g., chest discomfort in the long-term outcomes. Conclusions PROs and clinical outcomes were comparable between the two procedures. Further studies are required to determine the optimal treatment procedure.

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Section: Discussionmentioning

confidence: 73%

Comparison of patient-reported outcomes and clinical outcomes between pleurectomy and pleural covering added to thoracoscopic bullectomy for primary spontaneous pneumothorax

Kobayashi¹,

Ichimura²,

Kawabata³

et al. 2023

J Thorac Dis

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“…However, Ichimura et al. believed that there was a negligible impact on postoperative quality of life and pain in patients undergoing lobectomy through VAMT, with or without the use of a metal spreader ( 19 ). With the increasing maturity of minimally invasive technologies and progressive improvements in operating instruments, we suggest that experienced surgeons should consider not using a metal rib spreader in VAMT; however, when a metal rib spreader is used, it should have a width ratio not exceeding 2.5 times the width of a single intercostal space.…”

Section: Discussionmentioning

confidence: 99%

Would the width of a metal rib spreader affect postoperative pain in patients who undergo video-assisted mini-thoracotomy (VAMT)?

Wang

Ge²,

Fu³

et al. 2022

Front. Oncol.

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BackgroundHitherto, no study has evaluated postoperative pain in patients with non-small cell lung cancer (NSCLC) treated with video-assisted mini-thoracotomy (VAMT). In this study, we aimed to assess postoperative pain related to the width of the metal rib spreader in patients who underwent lobectomy using VAMT.MethodsWe retrospectively analysed the data of 94 consecutive patients with NSCLC who underwent lobectomy using VAMT at our institution between March 2019 and May 2022. We divided the patients into groups according to the width ratio of the rib spreader to that of a single intercostal space. Patients with width ratios ≤ 2.5 times were assigned to group A, and those with width ratios > 2.5 times were assigned to group B. Pre-, intra-, and postoperative data were collected and reviewed.ResultsWe successfully performed VAMT in 94 patients with NSCLC. Forty-five patients were in group A, and 49 were in group B. There were no intraoperative mortalities, although one patient, due to respiratory failure, experienced 30-day mortality. There were no significant differences between the two groups in terms of the blood loss volume, operative time, drainage time, postoperative complications, length of hospital stay, or number of lymph node stations explored and retrieved. The drainage volumes (Day 1–Day 3) were higher in group B than in group A (P < 0.05). The postoperative visual analogue scale (VAS) pain scores were significantly lower in Group A than in Group B at 12, 24, and 48 h (P < 0.05), although there was no significant difference in the VAS scores between the two groups at 72 h and 1 week postoperatively (P > 0.05).ConclusionThe smaller the width of the metal rib spreader used in surgery, the less pain experienced by the patient and the faster the recovery. Multicentre, randomised, controlled trials should be conducted in the future.

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Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery

et al. 2023

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Comparison of Postoperative Quality of Life and Pain with and without a Metal Rib Spreader in Patients Undergoing Lobectomy through Axillary Mini-Thoracotomy for Stage I Lung Cancer

Cited by 4 publications

References 29 publications

Comparison of patient-reported outcomes and clinical outcomes between pleurectomy and pleural covering added to thoracoscopic bullectomy for primary spontaneous pneumothorax

Comparison of patient-reported outcomes and clinical outcomes between pleurectomy and pleural covering added to thoracoscopic bullectomy for primary spontaneous pneumothorax

Would the width of a metal rib spreader affect postoperative pain in patients who undergo video-assisted mini-thoracotomy (VAMT)?

Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery

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