Original Research

Postthoracotomy Pain Syndrome Following Surgery for Lung Cancer: Symptoms and Impact on Quality of Life

Kathleen G. Hopkins, PhD, RN,¹ Leslie A. Hoffman, PhD, RN,² Annette De Vito Dabbs, PhD, RN,² Peter F. Ferson, MD,³ Linda King, MD,⁴ Linda A. Dudjak, PhD, RN,² Thomas G. Zullo, PhD,² and Margaret Q. Rosenzweig, PhD, RN²

¹Carlow University College of Health and Wellness, Department of Nursing, Pittsburgh, Pennsylvania; ²University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania; ³University of Pittsburgh School of Medicine, Department of Cardiothoracic Surgery, Pittsburgh, Pennsylvania; ⁴University of Pittsburgh School of Medicine, Department of General Internal Medicine, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania

Authors' disclosures of potential conflicts of interest are found at the end of this article.

Kathleen G. Hopkins, PhD, RN, Carlow University School of Health Sciences, Department of Nursing, 3333 Fifth Avenue, Pittsburgh, PA 15213. E-mail: kghopkins@carlow.edu

ABSTRACT

Abstract

Postthoracotomy pain syndrome (PTPS) is a common complication following thoracic surgery. Most studies examining the influence of PTPS on patient-reported symptoms include few patients managed using a minimally invasive approach. Associated sensory changes, potentially neuropathic in origin, are not well described. We therefore examined the symptoms and quality of life (QOL) of patients with and without PTPS who underwent a standard thoracotomy (n = 43) or minimally invasive surgery (n = 54). Patients in this prospective, cross-sectional study completed questionnaires to assess pain (McGill Pain Questionnaire), neuropathic symptoms (Neuropathic Symptom Questionnaire), symptom distress (Symptom Distress Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and QOL (Functional Assessment Cancer Therapy–Lung). Excepting younger age (p = .009), no demographic or surgical characteristic differentiated patients with and without PTPS. Patients with PTPS described discomfort as pain only (15.1%), neuropathic symptoms only (30.2%) or pain and neuropathic symptoms (54.7%). Scores differed between patients with and without PTPS for symptom distress (p < .001), anxiety and depression (p < .001), and QOL (p = .009), with higher distress associated with PTPS. Despite new surgical techniques, PTPS remains common and results in considerable distress. A focused assessment is needed to identify all experiencing this condition, with referral to pain management specialists if symptoms persist.

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