Postoperative Chronic Operation-related Symptoms After Minimally Invasive Lung Surgery: a Prospective Observational Protocol

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Aug 3

PMID 39097304

Authors

Yizhou Huang

Maohui Chen

Zhihui Wu

Peichang Liu

Shuliang Zhang

Chun Chen

Bin Zheng

Affiliations

Soon will be listed here.

Abstract

Introduction: Significant numbers of patients undergoing minimally invasive lung surgery develop chronic symptoms such as chronic pain and chronic cough after surgery, which may lead to a reduced quality of life (QoL). Despite this, there remains a dearth of high-quality prospective studies on this topic. Therefore, our study aims to systematically investigate the incidence and progression of long-term chronic symptoms following minimally invasive lung surgery, as well as changes in patient's psychological status and long-term QoL.

Methods: This is a single-centre, observational, prospective study that included patients with stage I non-small cell lung cancer or benign lesions. Prior to surgery, patients' baseline levels of chronic pain, chronic cough and sleep will be documented. Anxiety, depression and QoL assessments will be conducted using the Hospital Anxiety and Depression Scale (HADS) and the European Organisation for Research and Treatment of Cancer (EORTC) 30-item QoL Questionnaire (QLQ-C30). Following surgery, pain and cough will be evaluated during the initial 3 days using the Numeric Pain Rating Scale and Visual Analogue Scale score, with assessments performed thrice daily. Additionally, sleep status will be recorded daily during this period. Subsequently, postoperative chronic symptoms and QoL will be assessed at weeks 1, 2, 4, 12, 26 and 52. Chronic cough will be evaluated using the Leicester Cough Questionnaire, chronic pain will be assessed via the Brief Pain Inventory and McGill Pain Questionnaire while the EORTC QLQ-C30 questionnaire and HADS will provide continuous monitoring of QoL, anxiety and depression statuses. Data will also include the timing of chronic symptom onset, predisposing factors, as well as aggravating and relieving factors.

Ethics And Dissemination: Ethical approval was obtained from the Ethics Committees of Fujian Medical University Union Hospital. The findings will be disseminated in peer-reviewed publications.

Trial Registration Number: NCT06016881.

References

Bendixen M, Jorgensen O, Kronborg C, Andersen C, Licht P . Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol. 2016; 17(6):836-844. DOI: 10.1016/S1470-2045(16)00173-X. View

Linares-Moya M, Rodriguez-Torres J, Heredia-Ciuro A, Granados-Santiago M, Lopez-Lopez L, Quero-Valenzuela F . Psychological distress prior to surgery is related to symptom burden and health status in lung cancer survivors. Support Care Cancer. 2021; 30(2):1579-1586. PMC: 8727403. DOI: 10.1007/s00520-021-06537-7. View

Yotsukura M, Asamura H, Motoi N, Kashima J, Yoshida Y, Nakagawa K . Long-Term Prognosis of Patients With Resected Adenocarcinoma In Situ and Minimally Invasive Adenocarcinoma of the Lung. J Thorac Oncol. 2021; 16(8):1312-1320. DOI: 10.1016/j.jtho.2021.04.007. View

Xie M, Zhu Y, Zhou M, Wu S, Xu G, Xu S . Analysis of factors related to chronic cough after lung cancer surgery. Thorac Cancer. 2019; 10(4):898-903. PMC: 6449237. DOI: 10.1111/1759-7714.13021. View

Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S . The prevalence of psychological distress by cancer site. Psychooncology. 2001; 10(1):19-28. DOI: 10.1002/1099-1611(200101/02)10:1<19::aid-pon501>3.0.co;2-6. View

Zhang Y, Zhou R, Hou B, Tang S, Hao J, Gu X . Incidence and risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery: a retrospective study. BMC Surg. 2022; 22(1):76. PMC: 8892711. DOI: 10.1186/s12893-022-01522-1. View

Lee K, Goo J, Park S, Wi J, Chung D, Go H . Correlation between the size of the solid component on thin-section CT and the invasive component on pathology in small lung adenocarcinomas manifesting as ground-glass nodules. J Thorac Oncol. 2013; 9(1):74-82. DOI: 10.1097/JTO.0000000000000019. View

Yoon S, Hong W, Joo H, Kim H, Park S, Bahk J . Long-term incidence of chronic postsurgical pain after thoracic surgery for lung cancer: a 10-year single-center retrospective study. Reg Anesth Pain Med. 2020; 45(5):331-336. DOI: 10.1136/rapm-2020-101292. View

Balduyck B, Hendriks J, Sardari Nia P, Lauwers P, Van Schil P . Quality of life after lung cancer surgery: a review. Minerva Chir. 2009; 64(6):655-63. View

10.

Melzack R . The short-form McGill Pain Questionnaire. Pain. 1987; 30(2):191-197. DOI: 10.1016/0304-3959(87)91074-8. View

11.

Peng Z, Li H, Zhang C, Qian X, Feng Z, Zhu S . A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life. PLoS One. 2014; 9(2):e90014. PMC: 3938555. DOI: 10.1371/journal.pone.0090014. View

12.

Lancaster H, Heuvelmans M, Oudkerk M . Low-dose computed tomography lung cancer screening: Clinical evidence and implementation research. J Intern Med. 2022; 292(1):68-80. PMC: 9311401. DOI: 10.1111/joim.13480. View

13.

Chen W, Bai Y, Zhang L, Liu Y, Liu C, Liang J . Prevalence and Predictors of Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Surgery: A Systematic Review and Meta-analysis. Pain Ther. 2022; 12(1):117-139. PMC: 9845490. DOI: 10.1007/s40122-022-00439-0. View

14.

Ward N . The Leicester Cough Questionnaire. J Physiother. 2015; 62(1):53. DOI: 10.1016/j.jphys.2015.05.011. View

15.

Park S, Kang C, Hwang Y, Seong Y, Lee H, Park I . Risk factors for postoperative anxiety and depression after surgical treatment for lung cancer†. Eur J Cardiothorac Surg. 2015; 49(1):e16-21. DOI: 10.1093/ejcts/ezv336. View

16.

Mu T, Li J, Huang Q, Li X . Characteristics and Risk Factors for Persistent Cough After Pulmonary Resection. Ann Thorac Surg. 2022; 115(6):1337-1343. DOI: 10.1016/j.athoracsur.2022.05.054. View

17.

Lowery A, Krebs P, Coups E, Feinstein M, Burkhalter J, Park B . Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Support Care Cancer. 2013; 22(1):173-80. PMC: 3971862. DOI: 10.1007/s00520-013-1968-3. View

18.

Jin J, Du X, Min S, Liu L . Comparison of Chronic Postsurgical Pain Between Single-Port and Multi-Port Video-Assisted Thoracoscopic Pulmonary Resection: A Prospective Study. Thorac Cardiovasc Surg. 2022; 70(5):430-438. PMC: 9365528. DOI: 10.1055/s-0042-1744546. View

19.

Merlo A, Carlson R, Espey 3rd J, Williams B, Balakrishnan P, Chen S . Postoperative Symptom Burden in Patients Undergoing Lung Cancer Surgery. J Pain Symptom Manage. 2022; 64(3):254-267. PMC: 10744975. DOI: 10.1016/j.jpainsymman.2022.05.016. View

20.

Julian L . Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2012; 63 Suppl 11:S467-72. PMC: 3879951. DOI: 10.1002/acr.20561. View