Utilizing the visual analogue scale (VAS) to monitor and manage pain in post-operative skin wounds after thoracic surgery.

Due to the global increase in thoracic interventions, there is greater emphasis on refining post-operative care. The purpose of this study was to validate the visual analogue scale (VAS) as the valid method for measuring post-operative pain in thoracic surgery patients. From January 2020 to June 2022, this cross-sectional study investigated 240 adult patients who underwent elective thoracic surgeries in Thoracic Surgery Department of Heilongjiang Provincial Hospital. The participants were instructed to rate their discomfort using VAS at predetermined intervals after surgery. The following demographic and clinical information was recorded: age, gender, type of thoracic surgery, and history of chronic pain. Results showed a progressive decline in post-operative VAS scores over 72 h: 8.2 immediately after surgery, 6.0 at 24 h, 5.4 at 48 h, and 3.6 by 72 h. There were notable correlations between VAS scores and chronic pain history, with moderately positive correlation of 0.40 being observed. Mean scores for males and females were 3.8 and 3.9, respectively. The analysis by age revealed comparable mean scores for age categories below and above 40. With the exception of thoracic wall resection, which resulted in an average VAS score of 4.1 ± 1.0 (p < 0.05), the type of surgery had the minimal effect on variability of pain scores. The VAS is a reliable method for evaluating post-thoracic surgery discomfort. Given the substantial impact of pain history on VAS scores, there is an urgent need for personalized pain management strategies to improve post-operative care.

Hybrid robotic lobectomy with thoracic wall resection for superior sulcus tumor.

A major challenge in treating superior sulcus tumors is achieving complete surgical resection because of technical difficulties associated with the anatomical structures and approaches to the thorax. Our technique combines posterior minimally invasive thoracotomy with robot-assisted right upper lobectomy, thereby reducing the invasiveness of the surgical approach and postoperative complications, including wound pain. In the presented case, the tumor was located on the apical right upper lobe, directly invading the apical thoracic wall structures. Hybrid robotic and minimally invasive thoracotomy with thoracic wall resection was performed. The postoperative course was uneventful. The patient discharged from our hospital with minimal wound pain.

Thoracic Wall Reconstruction with Dorsal Diaphragmatic Traction and Preservation of Diaphragmatic Attachments in a Dog with Resection of the 11-13th Ribs.

A 9-year-old, 4.7 kg, spayed female Chihuahua presented with a 3.5 cm soft tissue sarcoma on the dorsal right thoracic wall. The tumor was resected, including the 11−13th ribs, resulting in a caudal dorsal thoracic wall defect. The defect was reconstructed with direct traction of part of the diaphragm dorsally, preserving the diaphragmatic attachments to the body wall, and the diaphragm was sutured to the surrounding ribs and muscles. Possible respiratory complications, including paradoxical respiration and exercise intolerance, were not observed during the perioperative or postoperative observation periods. This novel procedure is expected to be an option for caudal thoracic wall reconstruction when the diaphragmatic attachments remain intact even after the resection of the last rib. In addition, this procedure can be performed in dogs weighing <5 kg, with small pleural cavities and without respiratory disorders.

Extended double sleeve lobectomy combined with thoracic wall resection to treat a huge lung cancer.

A 58-year-old man came to our hospital with numbness of the left arm, fatigue, and fever. A huge solid mass with necrotic changes located in the left upper lobe was noted on the computed tomography scan. The tumor directly invaded the extrathoracic wall, the left main pulmonary artery, and the superior segment of the lower lobe. To avoid pneumonectomy, a combination of an extended double sleeve lobectomy and thoracic wall resection was performed. The postoperative course was uneventful. The patient has survived without any recurrence for 6 months postoperatively.