| Abstract: | OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture)in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in theDepartment of Thoracic Surgery of the Luzia de Pinho Melo Hospital dasClínicas and at the University of Mogi das Cruzes, both located in thecity of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age)undergoing posterolateral or anterolateral thoracotomy. The patients wererandomized into two groups by the type of thoracotomy closure: pericostal suture(PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during theimmediate and late postoperative periods was assessed by a visual analogic scaleand the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC,FEV1/FVC ratio, and PEF) were determined in the preoperative periodand on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group.Between the preoperative and postoperative periods, there were decreases in thespirometry variables studied. Those decreases were significant in the PS group butnot in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomypain than did those in the PS group, as well as showing smaller reductions in thespirometry parameters. Therefore, transcostal suture is recommended overpericostal suture as the thoracotomy closure technique of choice. |
