• B Passlick, C Born, H Mandelkow, W Sienel, and O Thetter.
• Klinik für Thoraxchirurgie, Asklepios Fachkliniken München-Gauting. Passlick@LRZ.uni-muenchen.de
• Chirurg. 2001 Aug 1;72(8):934-8; discussion 938-9.

BackgroundMinimally invasive techniques are now frequently used in general thoracic surgery. More than 30% of all minimally invasive procedures are operations in patients with spontaneous pneumothorax. Recently, it has been shown that the video-assisted approach compared to the standard anterolateral thoracotomy results in a significant reduction of the early postoperative pain. However, little is known about the influence of video-assisted surgery on long-term complaints.MethodsWe analyzed the frequency and characteristics of chronic complaints in 60 patients after video-assisted operations for spontaneous pneumothorax using a standardized questionnaire. For comparison, 27 patients after anterolateral thoracotomy for benign diseases were interviewed 24 months postoperatively using the same questionnaire.ResultsAfter minimally invasive surgery and a median observation time of 59 months, 19 (31.7%) out of 60 patients suffered from chronic complaints. Two of them (3.3%) required daily oral pain medication. On a visual analog pain scale (ranging from 0 to 100), 17 patients described a pain intensity of < 20 and 2 (3.3%) patients > 50. After thoracotomy 14 (51.8%) out of 27 patients suffered from chronic complaints, 5 (18.5%) of them with regular use of oral pain medications. The mean pain intensity (analog scale) was 3.6 points after minimally invasive operations and 14.4 points after thoracotomy (P = 0.01).ConclusionsIn conclusion, even after minimally invasive thoracic operations some patients suffer from chronic complaints. However, they are less frequent and of lower intensity than after thoracotomy.

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