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

• Published in: Annals of Thoracic and Cardiovascular Surgery Vol. 28; no. 2; pp. 129 - 137
• Main Authors: Ichimura, Hideo, Kobayashi, Keisuke, Gosho, Masahiko, Nakaoka, Kojiro, Yanagihara, Takahiro, Saeki, Yusuke, Sato, Yukio
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 2022
• Subjects: Humans; lung cancer; Lung Neoplasms - surgery; metal rib spreader; mini-thoracotomy; Original; Pain - surgery; postoperative pain; Quality of Life; Ribs - surgery; Surveys and Questionnaires; Thoracotomy - adverse effects; Treatment Outcome; lung cancer; mini-thoracotomy; metal rib spreader; quality of life; postoperative pain
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.oa.21-00148

Purpose: To evaluate postoperative patient-reported quality of life (QOL) and pain with and without a metal rib spreader (MRS) in patients with stage I lung cancer who underwent lobectomy through axillary mini-thoracotomy (AMT).Methods: This single-institution prospective observational study enrolled patients between January 2015 and April 2018. Their QOL and pain were evaluated using the EQ-5D and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire 30 items (QLQ-C30). The EQ-5D was completed preoperatively (Pre) and on days 1/3/5/7 (D1/3/5/7), at 1 month (M1), and at 1 year postoperatively (Y1). The EORTC QLQ-C30 was completed at Pre, M1, and Y1.Results: The data of 140 patients were analyzed (video-assisted without MRS: VA/noMRS: 67, AMT with MRS: AMT/MRS: 73). Although the AMT/MRS group had more preoperative comorbidities, longer operative times, and more blood loss than the VA/noMRS group, the EQ-5D visual analog scale scores were not significantly different at any assessment point (Pre/D1/D3/D5/D7/M1/Y1) (VA/noMRS: 82/48/60/67/73/77/85, AMT/MRS: 80/46/60/66/73/76/85). Postoperative pain in the EQ-5D descriptive system and the EORTC QLQ-C30 was comparable between the groups.Conclusion: VA/noMRS and AMT/MRS showed similar postoperative QOL and pain scores, indicating that MRS negligibly impacts the postoperative QOL and pain.