Médico Adjunto, Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Arch Bronconeumol. 2012 Jan;48(1):22-8. doi: 10.1016/j.arbres.2011.04.012. Epub 2011 Oct 22.
Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found. After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence.
剖胸术后疼痛是开胸术后患者高发的症状，也是多种术后并发症发病机制中的一个主要危险因素。开胸术后慢性疼痛的发生率较高。自最早的研究以来，这种疼痛一直被认为与肋间神经损伤有关，因此建议在开胸术时避免这些损伤。本综述通过对文献的系统回顾和对所发现研究提供的证据水平的分析，旨在为开胸术的闭合确定合适的手术程序。在对 MEDLINE、EMBASE、IME、IBECS 和 Cochrane Library 进行详尽搜索后，仅发现了少数研究。每一项研究都侧重于开胸术外科技术的不同方面，共同的重点是肋间神经的保留，结论的证据水平也不同。
