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Background <p>Chronic post-surgical pain (CPSP) is a prevalent complication following video-assisted thoracic surgery (VATS), significantly affecting long-term patient outcomes. This study aimed to evaluate the influence of uniport versus multiport VATS on the incidence of CPSP and postoperative recovery at six months.</p> Methods <p>Patients were stratified into uniport and multiport VATS groups, with propensity score matching (PSM). The primary endpoint was the incidence of CPSP at six months. The secondary endpoints comprise the short-term recovery outcomes within 30&#xa0;days postoperatively, the quality of life at six months and group-based trajectory modeling to characterize pain trajectories over six months.</p> Results <p>After PSM, 222 patients (111 per group) were included in the final analysis. A significant difference in postoperative pain intensity {3(1.8–4) vs 4(3–5), <i>P</i> = 0.007} was observed on postoperative day 3 (POD3). However, no significant difference in CPSP incidence at six months was detected between the uniport and multiport VATS groups. Multivariate logistic regression analysis of the entire cohort identified a high pain score on POD3 as an independent risk factor for CPSP development. Pain trajectory analysis revealed three distinct postoperative pain patterns over the six-month period. Patients in the high pain trajectory required more remedial analgesia and were more likely to develop CPSP.</p> Conclusions <p>Uniport VATS was not associated with a lower incidence of CPSP compared to multiport VATS at six months postoperatively. A high pain score on POD3 emerged as a significant predictor of CPSP.</p>

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Postoperative chronic pain following uniport vs. multiport video-assisted thoracoscopic surgery: insights from a propensity score-matched analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Yali Tian,
  • Yiwei Zhong,
  • Min Wang,
  • Shujie Niu,
  • Siyi Wang,
  • Huaye Xu,
  • Bingbing Li

摘要

Background

Chronic post-surgical pain (CPSP) is a prevalent complication following video-assisted thoracic surgery (VATS), significantly affecting long-term patient outcomes. This study aimed to evaluate the influence of uniport versus multiport VATS on the incidence of CPSP and postoperative recovery at six months.

Methods

Patients were stratified into uniport and multiport VATS groups, with propensity score matching (PSM). The primary endpoint was the incidence of CPSP at six months. The secondary endpoints comprise the short-term recovery outcomes within 30 days postoperatively, the quality of life at six months and group-based trajectory modeling to characterize pain trajectories over six months.

Results

After PSM, 222 patients (111 per group) were included in the final analysis. A significant difference in postoperative pain intensity {3(1.8–4) vs 4(3–5), P = 0.007} was observed on postoperative day 3 (POD3). However, no significant difference in CPSP incidence at six months was detected between the uniport and multiport VATS groups. Multivariate logistic regression analysis of the entire cohort identified a high pain score on POD3 as an independent risk factor for CPSP development. Pain trajectory analysis revealed three distinct postoperative pain patterns over the six-month period. Patients in the high pain trajectory required more remedial analgesia and were more likely to develop CPSP.

Conclusions

Uniport VATS was not associated with a lower incidence of CPSP compared to multiport VATS at six months postoperatively. A high pain score on POD3 emerged as a significant predictor of CPSP.