RecruitingNCT07184463

A Study of Pain Reduction After Pulmonary Resection by RATS-TT, RATS-OTC, and Hybrid RATS.

Chronic Pain After Thoracic Surgery: Towards a New Standard? A Comparative Prospective Study of Pain Reduction After Pulmonary Resection by RATS-TT, RATS-OTC, and Hybrid RATS.

Sponsor

Centre hospitalier de l'Université de Montréal (CHUM)

Enrollment

120 participants

Start Date

Dec 5, 2025

Study Type

OBSERVATIONAL

Conditions

Thoracic Surgery Video-assisted Thoracic Surgery Robotic-assisted Thoracic Surgery

Summary

Pulmonary resections are key in treating lung neoplasms, with techniques adapted to tumor size and location. Minimally invasive approaches like VATS have replaced open thoracotomy, but intercostal trocar placement can lead to nerve injury and chronic pain. Robotic-assisted thoracic surgery (RATS) is usually done via a transthoracic (RATS-TT) approach using intercostal trocars. A newer "out of cage" method (RATS-OTC), using subcostal or subxiphoid ports, avoids intercostal access, potentially reducing nerve damage. A French study showed less opioid use and acute pain with RATS-OTC, but chronic pain outcomes are still unknown. At CHUM, a hybrid RATS technique (RATS-TTH) is also used-intercostal for instruments, but with out-of-cage specimen extraction-to limit intercostal trauma.

Eligibility

Min Age: 18 Years

Inclusion Criteria2

Patients aged 18 years and older
American Society of Anesthesiologists (ASA) score 1-3

Exclusion Criteria3

Language barrier, psychiatric, physical or mental condition making pain assessment impossible despite prior education
Patient refusal to participate
Patients reoperated by VATS or thoracotomy in the postoperative period in the context of the occurrence of complications

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Interventions

OTHEREvaluation of chronic pain at 3 and 6 months after thoracic surgery

The presence of persistent postoperative pain, defined as ipsilateral chest pain (on the same side as the surgery) occurring at rest and/or with coughing on a daily basis. Assessed by a 'yes' or 'no' response when asked at 3 and 6 months postoperatively.