Chronic chest pain and paresthesia after video-assisted thoracoscopy for primary pneumothorax

Maria Cattoni, Nicola Rotolo, Maria Giovanna Mastromarino, Giuseppe Cardillo, Mario Nosotti, Paolo Mendogni, Alessandro Rizzi, Federico Raveglia, Alessandra Siciliani, Erino Angelo Rendina, Lucio Cagini, Alberto Matricardi, Pier Luigi Filosso, Erika Passone, Stefano Margaritora, Maria Letizia Vita, Pietro Bertoglio, Andrea Viti, Lorenzo Dominioni, Andrea Imperatori

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This study aims to identify clinical and surgical risk factors for chronic chest pain and paresthesia after video thoracoscopic surgery for primary spontaneous pneumothorax. Methods: We retrospectively collected the data of 1,178 consecutive patients <40-years-old undergoing video thoracoscopic surgery for primary spontaneous pneumothorax in 9 Italian centers in 2007-2017. Cases with <2-month follow-up were excluded, leaving 920 patients [80% male; median age: 21 (IQR, 18-27) years] for statistical analysis. The following risk factors for chronic chest pain and chronic paresthesia were assessed by univariable and multivariable Cox regression model: age, gender, cannabis smoking, video thoracoscopy ports number, pleurodesis technique (partial pleurectomy/pleural electrocauterization/pleural abrasion/talc poudrage), chest tube size (24/28 F), postoperative chest tube stay. Results: Blebs/bullae resection with pleurodesis was performed in 732 (80%) cases; pleurodesis alone in 188 (20%). During a median follow-up of 68 (IQR: 42-95) months, chronic chest pain developed in 8% of patients, chronic chest paresthesia in 22%; 0.5% of patients regularly assumed painkillers. Chronic chest pain was independently associated with partial pleurectomy/pleura abrasion (P<0.001) and postoperative chest tube stay (P=0.019). Chronic chest paresthesia was independently associated with pleurodesis by partial pleurectomy (P<0.001), chest tube stay (P=0.035) and 28 F chest tube (P<0.001). Conclusions: After video thoracoscopic surgery for primary spontaneous pneumothorax, the incidence of chronic chest pain and paresthesia was significantly lower when pleurodesis was performed by pleural electrocauterization or talc poudrage, and chest tube was removed early. A 24 F chest tube was associated with lower risk of chronic chest paresthesia.

Original languageEnglish
Pages (from-to)613-620
Number of pages8
JournalJournal of Thoracic Disease
Volume13
Issue number2
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Chronic chest pain
  • Chronic chest paresthesia
  • Primary spontaneous pneumothorax
  • Video-assisted thoracoscopic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Fingerprint

Dive into the research topics of 'Chronic chest pain and paresthesia after video-assisted thoracoscopy for primary pneumothorax'. Together they form a unique fingerprint.

Cite this