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 .
A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery.
OBJECTIVE Our question naire study set out to assess the prevalence of chronic pain after thoracic surgery , the contribution of the neuropathic component of chronic pain and the impact of chronic pain on patients ' lives . METHODS A question naire was sent to 1152 patients who had undergone thoracic surgery in our department between 7 months and 7 years ago . The question naire was design ed specifically for the study and included questions on neuropathic symptoms . Responses were correlated with data from our prospect ively entered data base for analysis . RESULTS Nine hundred and forty-eight people were included in the study , of which 600 responded ( 63 % ) . Prevalence of chronic pain is 57 % at 7 - 12 months , 36 % at 4 - 5 years and 21 % at 6 - 7 years . Patient age , consultant and time since the operation all have significant effects . Surgical approach ( video-assisted thoracoscopic surgery , thoracotomy ) and diagnosis are not significant . Thirty-nine percent of those with pain take analgesia , 46 % felt their pain is their worst medical problem and 40 % reported it limits their daily activities . The prevalence of each neuropathic symptom is between 35 and 83 % . The presence of a neuropathic symptom is associated with significantly more severe pain , more analgesia use and pain more likely to limit daily activity . CONCLUSIONS Chronic pain has a significant prevalence and impact on patients ' lives for several years after thoracic surgery . Nerve dysfunction is associated with more severe pain , a greater impact and tends to persist . The reason for the individual consultant being an important factor in post-thoracotomy pain needs further investigation
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 .