However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .
Women’s Recovery from Sternotomy-Extension (WREST-E) study: examining long-term pain and discomfort following sternotomy and their predictors
Objective : To examine incision and breast pain and discomfort , and their predictors in women 12 months following sternotomy .  Design : Extension survey following participation in a clinical trial . Setting : 10 Canadian centres . Patients : Women ( n = 326 ) who completed the Women ’s Recovery from Sternotomy Trial . Interventions : None . Main outcome measures : Pain and discomfort data ( numeric rating scales ) collected by st and ardised interview at 5 days , 12 weeks and 12 months following sternotomy . Results : More patients reported having incision or breast discomfort ( 46.6 % ) than pain ( 18.1 % ) at 12 months postoperatively . No symptoms at 5 days postoperatively were significantly associated with symptom presence at 12 postoperative months . However , having incision pain and discomfort as well as breast pain and discomfort at 12 postoperative weeks was associated with incision pain ( odds ratio ( OR ) = 3.26 , 95 % confidence interval ( CI ) 1.51 to 7.07 ) , incision discomfort ( OR = 4.87 , 95 % CI 3.01 to 7.88 ) , breast pain ( OR = 9.36 , 95 % CI 3.91 to 22.38 ) and breast discomfort ( OR = 6.42 , 95 % CI 3.62 to 11.37 ) , respectively , at 12 postoperative months . Increasing chest circumference was associated with having ongoing incision pain ( OR = 1.12 , 95 % CI 1.03 to 1.21 ) and breast pain ( OR = 1.10 , 95 % CI 1.00 to 1.22 ) . Harvesting of bilateral internal mammary arteries ( IMAs ) was associated with having ongoing incision pain ( OR = 4.71 , 95 % CI 1.54 to 14.3 ) , while harvesting only the left IMA was associated with having ongoing breast pain ( OR = 2.78 , 95 % CI 1.06 to 7.32 ) and breast discomfort ( OR 1.80 , 95 % CI 1.02 to 3.19 ) . Conclusions : Patients reported incision and breast pain and discomfort as long as 12 months post-sternotomy . Improved management of postoperative pain and discomfort up to at least 12 weeks following surgery may render reduced long-term pain and discomfort symptoms
However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .