• Juliana Duarte Leandro, Olavo Ribeiro Rodrigues, Annie France Frere Slaets, Aurelino F Schmidt Jr, and Milton L Yaekashi.
• University of Mogi das Cruzes, Mogi das Cruzes, Brazil.
• J Bras Pneumol. 2014 Jul 1;40(4):389-96.

ObjectiveTo compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function.MethodsThis was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60.ResultsPain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group.ConclusionsThe patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice.

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