Postoperative Pain Reduction and Clinical Value of Uniportal Video-Assisted Thoracic Surgery: A Secondary Analysis of the J-RATSIG 01 Study.

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer Pub Date : 2025-05-12 DOI:10.1016/j.cllc.2025.05.001

Takuya Watanabe, Masayuki Tanahashi, Masato Chiba, Kumiko Hashimoto, Noriaki Sakakura, Mikio Okazaki, Shoichi Mori, Masaki Hashimoto, Toyofumi Fengshi Chen-Yoshikawa, Masahiro Miyajima, Isao Matsumoto, Masayuki Shitara, Motoshi Takao, Toru Ogura, Koji Kawaguchi

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引用次数: 0

Abstract

Background: The J-RATSIG 01 multi-institutional prospective study found robot-assisted thoracic surgery to be inferior to video-assisted thoracic surgery (VATS) in terms of postoperative pain. Because reducing the number of ports was linked to pain reduction, we conducted a secondary analysis comparing uniportal VATS (U-VATS) and multiportal VATS (M-VATS).

Methods: This analysis included 205 patients who underwent anatomical lung resection using VATS at 12 institutions. Postoperative pain was assessed using the numerical rating scale (NRS) and painDETECT questionnaire (PDQ) on postoperative days 10, 30, and 90.

Results: Ninety-five patients underwent U-VATS, and 110 underwent M-VATS. The U-VATS group had significantly shorter operation times, chest tube duration, and hospital stay than the M-VATS group (146 vs. 180 min, 2.1 vs. 2.6 days, 4.8 vs. 6.4 days, respectively). Analgesic use was also significantly lower in the U-VATS group at all postoperative phases (64% vs. 90%, 14% vs. 52%, and 1% vs. 15%, all P < .001). NRS scores were significantly lower in the U-VATS group on postoperative days 10 (1.2 vs. 1.9, P < .001) and 30 (0.7 vs. 1.5, P < .001). The PDQ scores were consistently lower in the U-VATS group at all postoperative phases (all P < .001). A multivariate analysis showed that U-VATS significantly reduced the odds of an NRS score of > 3 on postoperative days 10 and 30 (odds ratio: 0.26, 95% CI: 0.08-0.84; odds ratio: 0.09, 95% CI: 0.01-0.76).

Conclusions: U-VATS significantly reduced postoperative pain and was associated with shorter operation times, chest tube duration, and hospitalization than M-VATS.

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单门视频辅助胸外科手术术后疼痛减轻及临床价值：J-RATSIG 01研究的二次分析

背景：J-RATSIG 01多机构前瞻性研究发现，机器人辅助胸外科手术在术后疼痛方面不如视频辅助胸外科手术（VATS）。由于减少端口数量与疼痛减轻有关，我们对单门VATS （U-VATS）和多门VATS （M-VATS）进行了二次分析。方法：本研究纳入了12家机构采用VATS进行解剖性肺切除术的205例患者。术后10、30、90天采用数值评定量表（NRS）和painDETECT问卷（PDQ）对患者进行疼痛评估。结果：U-VATS 95例，M-VATS 110例。U-VATS组的手术时间、胸管持续时间和住院时间明显短于M-VATS组（分别为146 vs 180分钟、2.1 vs 2.6天、4.8 vs 6.4天）。U-VATS组在术后各阶段镇痛药的使用也显著降低（64% vs. 90%, 14% vs. 52%, 1% vs. 15%，均P < 0.001）。U-VATS组NRS评分在术后第10天（1.2比1.9,P < 0.001）和30天（0.7比1.5,P < 0.001）显著降低。U-VATS组在术后各阶段的PDQ评分均较低（P < 0.001）。多因素分析显示，U-VATS显著降低了术后第10天和第30天NRS评分为bb0.3的几率(优势比：0.26,95% CI: 0.08-0.84；优势比：0.09,95% CI: 0.01-0.76)。结论：与M-VATS相比，U-VATS可显著减轻术后疼痛，缩短手术时间、胸管时间和住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical lung cancer 医学-肿瘤学

CiteScore

7.00

自引率

2.80%

发文量

159

审稿时长

24 days

期刊介绍： Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.