Muscle sparing thoracotomy: a biomechanical analysis confirms preservation of muscle strength but no improvement in wound discomfort

Khan, Iftikhar Hussain; McManus, Kieran; McCraith, Aveen; McGuigan, James A.

doi:10.1016/s1010-7940(00)00591-1

Cited by 53 publications

(24 citation statements)

References 17 publications

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“…Two retrospective studies found no difference between the classic posterolateral approach and the musclesparing posterolateral approach. 15,16 A subanalysis from a prospective study also found no difference in PTPS based on incision type. 17 Finally, 2 additional retrospective studies found the anterior approach to result in less PTPS.…”

Section: Surgical Factorsmentioning

confidence: 98%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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This article provides a concise overview of post‐thoracotomy pain syndrome, describes anesthetic and surgical factors that have been investigated to reduce the incidence of the syndrome, and explores the effectiveness of various treatments for this condition. Although some interventions (both procedural and pharmacologic) have been investigated in both preventing and treating post‐thoracotomy pain syndrome, definitive studies are lacking and firm conclusions regarding the benefit of any intervention cannot be drawn. The problem is compounded further by our lack of understanding of the pathophysiologic mechanisms underlying the development of chronic pain after surgery. Going forward, it will be important to elucidate these mechanisms and conduct well‐designed trials involving novel therapeutic agents for both prevention and treatment of post‐thoracotomy pain syndrome. Mt Sinai J Med 79:133–139, 2012. © 2012 Mount Sinai School of Medicine

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Section: Surgical Factorsmentioning

confidence: 98%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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“…In some publications, anterolateral thoracotomy and median sternotomy have been reported to cause less pain intensity than posterolateral thoracotomy. In order to prevent the development of PTPS, muscle sparing surgery was not found superior to posterolateral incisions [21,28].…”

Section: Risk Factorsmentioning

confidence: 99%

Current treatment options for post-thoracotomy pain syndrome: a review

Yakşi¹,

Yakşi²

2017

Curr Thorac Surg

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Thoracotomy is one of the most painful surgical procedures known. Chronic pain in the postoperative period after thoracotomy is a common complication. Post-thoracotomy pain syndrome (PTPS) is a chronic pain with neuropathic and non-neuropathic components, continuing after 2 months of thoracotomy, causing disability by affecting the daily activities and functions of patients. Patients generally describe neuropathic symptoms such as hyperalgesia, allodynia, hypoesthesia at the site of the incision or related dermatomes. Etiology includes preoperative, intraoperative and postoperative factors. Although the mechanism of PTPS formation is not clear yet, the most common cause is the intercostal nerve injury. PTPS treatment is complex because of the neuropathic component of the pain.The risk of PTPS formation can be reduced by controlling early pain before the onset of the disease.When pain occurs, medical treatments are implemented and also minimally invasive interventional procedures could be performed if necessary.

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“…Even muscle-sparing incisions appear to have no major advantage over posterolateral incisions (45). Overall, variation in surgical techniques has not been shown to reduce subsequent pain (46).…”

Section: Mechanism Of Post-thoracotomy Painmentioning

confidence: 99%

Postthoracotomy Pain Management Problems

Gerner

2008

Anesthesiology Clinics

219

130

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SynopsisPain after thoracotomy is very severe, probably the most severe pain experienced after surgery. It is also unique as this pain state has multiple implications, including respiratory failure due to splinting; inability to clear secretions by effective coughing, with resulting pneumonia; and facilitation of the often incapacitating chronic pain: the post-thoracotomy pain syndrome. Thoracic epidural analgesia has greatly improved the pain experience and its consequences and has been considered the 'gold standard' for pain management after thoracotomy. This view has recently been challenged by the use of paravertebral nerve blocks. Nevertheless, severe ipsilateral shoulder pain and the prevention of the post-thoracotomy pain syndrome remain the most important challenges for post-thoracotomy pain management.

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Muscle sparing thoracotomy: a biomechanical analysis confirms preservation of muscle strength but no improvement in wound discomfort

Cited by 53 publications

References 17 publications

Preventing Post‐Thoracotomy Pain Syndrome

Preventing Post‐Thoracotomy Pain Syndrome

Current treatment options for post-thoracotomy pain syndrome: a review

Postthoracotomy Pain Management Problems

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